Tuesday, June 30, 2009
for many days since late June. After reading
the Posts over the last week we've been sincerely
moved by your dedication to your brother. This
love and compassion reminded us of a song from
the 60's by a group called the Hollie's. This song
exemplifies what all of you are about!
He Ain't Heavy, He's my brother
The road is long
With many a winding turn
That leads us to who knows where
Who knows when
But I'm strong
Strong enough to carry him
He ain't heavy, he's my brother
So on we go
His welfare is of my concern
No burden is he to bear
We'll get there
For I know
He would not encumber me
He ain't heavy, he's my brother
If I'm laden at all
I'm laden with sadness
That everyone's heart
Isn't filled with the gladness
Of love for one another
It's a long, long road
From which there is no return
While we're on the way to there
Why not share
And the load
Doesn't weigh me down at all
He ain't heavy, he's my brother
Monday, June 29, 2009
As I read, two skilled therapists entered and quickly the room came to life. Isabella, the occupational therapist, jotted down some notes about Daniel's interests including hiking and traveling. It turns out that she has a shared interest with Daniel because she also knows jiu jitsu. Theresa, the physical therapist, also showed a genuine interest in Daniel and his family. Together they make a confident and expert team.
Working in tandem, the skilled therapists, quickly began to evaluate Daniel. He favors his left side they said. And that we should work with him to shift his focus to his right side; he needs to pay attention to his right side. On the PT side: Daniel is hyper extending...he is pushing his legs out. Daniel is very tight! His hip flexion was at 90 degrees which is good. His knees bent a little less than that, but his ankles are especially tight. His toes are pointing downward towards the foot of the bed constantly. This hyperextension can lead to contracture: the permanent shortening of muscles or tendons due to continued stress exerted on that muscle or tendon. Contracture cannot be excercized or stretched away.
The restorative therapists will work with Daniel for approximately 30 to 40 minutes a day, but this is not nearly enough!
We can help with range of motion excercises. Look for the diagrams that show how to perform these excercises on the cork-board with the family pictures. Or ask anyone who has done them to teach you how to do them, they are simple and easy to learn. As the RT puts it, WHEN Daniel is ready to walk, the more flexibility he has the better.
The highlight of my visit today was when I was able to sit next to Daniel side by side holding him up along with the help of the therapists (as they evaluated). I had my arm around him as I propped him up and his face was next to mine. Are words necessary to describe the joy of once again being able to sit next to my brother, shoulder to shoulder, heart to heart, in unity of spirit?
Skilled therapy really begins once Daniel is able to participate even minimally in his own rehabilitation. When he is able to follow commands and move on his own. Another high point today was that it was evident to the therapists and myself that Daniel was able to loosen his grip when asked: he was able to open and close his left hand on command after several repititions. The lesson here is that Daniel must relearn everything. It is not enough to simply tell him to do something, one must actually help him do it. These repititions will help train his muscles as neurons create new paths and circuits in his brain. Every interaction counts!
Sunday, June 28, 2009
The immediate goal for Daniel is decanulation within 8 to 10 days.. Decanulation means that the trach-tube comes off completely. In order for this to happen Daniel must pass several tests. First, he must be able to breathe on his own without ventilator assist. Next, the RT would attach a one-way valve (known as a pmv or "speaking valve" because it permits patients to speak) that would allow Daniel to exhale through his nose and mouth. If Daniel passes this test, that is if he is able to exhale through nose and mouth, the next step would be to plug the trach entirely to see if Daniel can both inhale and exhale through nose and mouth.
The final most critical test is the swallow test. This test inolves the use of ice chips with food coloring. Daniel is given ice chips through his mouth (I'll bet he would love to taste ice once again, think of how refreshed he will feel) with the hope that Daniel will SWALLOW these into his belly via his esophogus. If, after suctioning his lungs, there is any evidence of food coloring or dye, then the ice has gone down the proverbial "wrong pipe." If this is the case then Daniel will have to practice swallowing--a skill we take for granted and do automatically.
The RT points out that youth is again on Daniel's side. However, because he isn't as "awake" and "alert" as we'd like he cannot consciously correct his swallowing as we do when we begin to choke. So when Daniel finally passes the swallow test and he has been breathing independently then the trach has served its purpose and can be removed. The hole, in his throat, once healed, will hardly be noticed.
Kindred has a very high success rate with this kind of rehabilitation. Then what? Well, Daniel will be evaluated for occupational, physical or speech therapy. Kindred has all of these specialists "in-house." My hope is we'll be able to access these resources for Daniel for some time. Kindred's multi-prong approach to acute care and rehabilitation is perfect for my perfect brother!
Thanks again and with Love,
Saturday, June 27, 2009
Right now Daniel is relaxing listening to Manu Chao. Daniel perks up to sudden noises. When Alfredo arrived at 6pm Daniel sighed happily and his eyes tracked Fredo's voice and movements.
Man Kindred has a homey as in kin kind of feel that belies its corporate, service oriented success. Kindred was #1 on Fortune's The World's Most Admired Companies in the category of Health Care Medical Facilities. 9 criteria are used to rank the most notable companies including innovation,quality of products and social responsibility. Kindred is situated in North Park,and Kindred's nursing staff mirrors the diversty of the community it serves. There are liasons that are active in the community and that assist families in planning for the care of their loved ones.
Kindred is a long term acute care facility: How will we use the resources available to us here at Kindred to plan for Daniel's future?
Thank you to all for your generosity and love. Thanks to the support of friends and family Daniel is still fighting. It is now 8pm and Daniel has been breathing on his own for 13 hrs, again exceeding expectations.
Friday, June 26, 2009
"Adopt the pace of nature: her secret is patience."
~ Ralph Waldo Emerson
Today, Daniel is 'working out' with the breathing interval
exercise routine. He originally started with 4 hours on his
own, 4 hours with the ventilator assist. When we arrived
Chuy indicated that Daniel had no problems with the 4 hour
routine, so they tested him to see if he could push it to 10
hours. Well, he handled the first 10 hour interval and that
seemed to be stretching his endurance, but with the interval
of rest he came back to tackle another 10 hours.
For those of you that have run cross country or track you
readily see this as a conditioning regime or 'workout'. The
purpose of which is not only for muscular conditioning but
for conditioning the body/lungs to perform in a 'anerobic'
state, that is with less oxygen. For Daniel, the muscular
conditioning will come later in physical therapy.
This regime also increases the lung capacity, increases
the strength and pumping capacity of the heart, and
increases the blood carrying capacity of arteries and
veins (making these vessels more pliable).
Kindred Hospital has been a pleasant surprise. The
facility has the techinical equipment required by Daniel,
there is a respiratory technician on staff 24/7, the nursing
personnel are caring and professional. Daniel is in a
private room and the atmosphere is pleasant.
The swelling from the bone flap replacement surgery is
slowly going down. Daniel has his eyes open for long
periods of time, then he nods off for 15 minutes.
Daniel is looking better and there is a sense that it is
only a matter of time now. This phase of Daniel's
recovery is not without anxiety. As long as he
remains healthy, time will take care of the rest. Keep
in mind that he hasn't had any chronic problems with
organs. He has that in his favor.
Take care of one another.......
Chuy Miranda ~ Cathy, Olivia, Danielito, Nayeli
Michelle ~ Margarita, Victor, Cristina ~ Che
Amelia Pulido ~ Chino (Jaime) and family
Wednesday, June 24, 2009
Maria and I have returned from Baja and have visited
Daniel several times in the last few days.
I want to update Chuy's post with a few items that
have transpired since this morning.
First, Daniel's breathing is not as rigorous as it was prior
to the last surgery, understandably. However, it is
expected to return to those levels exhibited prior to the
'storming' episodes. The respiratory therapist will start
a protocol with Daniel whereby he will be allowed to
breathe without the ventilator for four hours then will be
returned to ventilator assist for four hours. They will
monitor this regime for the next 10 days. A form of
interval training whereby the expected outcome will be
to build his lung capacity up to the point where he can
function without the ventilator. Daniel, we know you can
do this! The ventilator will always be attached to the
'trache' in the event of an emergency.
Daniel has had his eyes wide open during the several hours
of our visit. Very pleased to inform you that the 'storming'
episodes have stopped!! This is a very encouraging sign.
Visible observations: Daniel looks exceptionally good consider-
ing he just had the bone flap replaced last Saturday. His color
is great, his vital signs are within expected norms.
Prior to April 29, Daniel was in very good physical condition.
All the surgeries, infections, treatments, episodes has had a
debilitating toll on his stamina. Yet, he has endured.
Considering Daniel's brain and processing skills, it is safe to say
that the original trauma has left him with a quantifiable measure
of the state of coma that is borderline between severe and moderate.
That intangible called the human spirit has brought him through
57 days of extremely challenging effects on his immune system
and his physiology.
It has been no small task for the countless health professionals
that have been at his side during this perilous journey. Their
dedication to the care of patients has given all of us a deep sense
of security knowing that while we sleep Daniel is in good hands.
Medical science is pushing the boundaries of life saving techniques
and procedures, giving countless people a new lease on life.
There is an ever increasing number of case studies of individuals
with brain trauma injuries that are similar to Daniel's, that have
added to the statistical results of persons regaining consciousness.
This has been very encouraging and has renewed the hopes of
all families living with this challenge. Keep your hopes up
and keep those prayers coming.
A brief word about the how this has affected all of us.
It has been one very emotional, physical and mentally fatiguing
This has been devastating for Daniel's brothers, Alfredo,
Victor, and Nando. At best, we can observe and only try to
understand what they are experiencing. These guys are tough
and have been there for Daniel every inch of the way.
None of us can truly comprehend the effect all of this has had
on Cathy, Margarita, and Victor. The love and courage they
have demonstrated day in and day out over the last 57 days has
been exemplary and will surely carry them through many
more trials. This we have witnessed. They are exceptional people.
As relatives and friends we will continue to stand with them and
offer a shoulder to lean on when their load becomes a little
It is summer and plans may take you and your family on
long awaited vacations. Your jobs and never ending
responsibilities must come first.
Making time to visit Daniel has not gone unnoticed.
If I may speak for the immediate family, they are extremely
grateful and appreciative for the incredible support, the visits,
the donations, the prayers, the solace, and infinite acts of kindness
and love. Daniel's support team has gone above and beyond.
Take care of one another........
The right side of his face is still swollen from his bone flap surgery, but his heart rate and breathing is excellent. There are no reports of any storming in his brain, and the respiratory therapist is going to start allowing Daniel to breathe on his own for a couple of hours and increase the time as the days go by. The goal is to have him breathing on his own as soon as possible. Don't worry, he explained all the monitoring systems that are in place to ensure Daniel will be okay in case there are any issues with his breathing.
There is some unexpected swelling in his right cheek, Cathy will have the Doctor look at it today to make sure all is good (fyi: Doctors make daily patient rounds at Kindred). Kindred came highly recommended as a top facility and so far so good, if you would like further information on this facility and directions you can visit http://www.kindredsandiego.com/
Their visiting hours are from 9:00a.m. to 8:00p.m. and no visitors under the age of 15 are allowed. They are flexible with the visiting hours as long as were quiet, but not with the age rule.
After a conversation with Cathy and Margarita, they were very much open to possibly trying to set up some sort of schedule to make sure there is someone keeping Daniel company on a daily basis. This would definitely help relieve some of the load on them, so they can be okay knowing someone will be there. We have devised a plan to try to do it by a.m. and p.m. shifts, it is not necessary for someone to be there all the time, but if we can keep a consitant eye on him that would be cool. So if any of you are interested in this please let us know.
Monday, June 22, 2009
Daniel will be moved today at 7pm to a new facility in San Diego. The new site is called:
Kindred Health Care--Long Term Acute Care
1940 El Cajon Blvd
San Diego, CA 92104
Directions are simple and the new location is near Sharps. Simply take 163 south, you will pass Highway 8, exit east on Washington St., and Washington St. merges or turns into El Cajon Blvd. Look for the address 1940 El Cajon Blvd. Or, you can "Map Quest" the above address.
More good news. Daniel's surgery to place back the bone flap to his skull went well. The right side of his face is a little swollen from the surgery, but he has his eyes open and seems to be relaxed--no more "storming." All good news since Daniel has been sleeping and storming a little too much the last couple of weeks. Alfredo noticed that his brother seems to be more attentive and looks much better after the surgery to his skull.
One last note, Dr. Tantuwaya commented to Margarita that the initial two surgeries to take care of Daniel's aneurysm were a "total success." The Doctor must have took a quick look at his initial surgical work and Daniel's brain as he re-placed the bone flap to the skull. Alright Danny!!! Keep fighting brother.
Friday, June 19, 2009
Thursday, June 18, 2009
Tuesday, June 16, 2009
Tests for infection due to ventilator connection are negative. Nurses will continue to monitor and control "colonized bacteria" from developing into infections. In the clear right now. Other possible good news for this week is the possibility of placing the "flap" back on to Daniel's skull. Meaning, the bone portion that was removed from Daniel's skull will be put back in place to cover the brain. This would require, of course, surgery in the next couple of days. However, the doctor has not mentioned any dates as of when this procedure would take place.
Doctor will be coming in sometime later today to look over Daniel's chart and maybe decide on a date for the surgery. Will update everyone once I know the specifics.
Monday, June 15, 2009
Sunday, June 14, 2009
Daniel is now on the 3rd floor in room 311. He was moved here two nights ago. My mom stayed with him last night and was there when I arrived around 11:00am. His heartrate was up a bit and his breathing has been erratic. He is also running a high temperature. Nurses have given tylenol and cold compresses for the fever and ativan, a relaxant, to get his heartrate back to normal. He is also getting a blood clot thinner through I.V. This has helped reduce the swelling he had in his right arm and hand.
He settled into a nice nap shortly after recieving the ativan and was calm and peaceful by 1pm.
According to the nurses, these issues are related to having been in bed for this long. Also, Daniel's brain isn't working as effeciently as normal due to the neurological damage he has sustained from his injury. The nurse explained to me that whenever tissue in your body is damaged it "weeps" fluid. Similarly, Daniel's brain continues to "weep" fluid. This is why Daniel is always upright in his bed; so that the cerebrospinal fluid can drain more easily through the shunt. The shunt is continually adjusted and they move his body around to avoid sores or infections from staying in one position for too long.
Cathy was away at a soccer tournament for Danielito. The word is that the Hawks have taken home another trophy. Way to go Hawks, way to go Danielito!!!!
Re-Presente! Victor, Magarita, Cristina, Vero and George, Valeria, George Jr., Mando, Diana, Margarito, Deanna, David Serrano y su esposa, Chuy and Adrian...Langston Hughes
Friday, June 12, 2009
Today was a good day for Daniel, his vitals were good, and a good part of the day he was breathing on his own, still with the ventilator hooked up, but on his own. His neurosurgeon checked him around 3pm and nothing new was reported.
The meeting that was to be held today with the Doctors and Cathy, Margarita, Victor, and Fredo was rescheduled at the request of the medical team. It was never clear on the purpose of the meeting and a future date was not given at this time.
Daniel was chillin' today, he got an awesome foot and leg massage from Cathy and Irene, all while listening to some Bob Marley.
Fredo was telling him about attending closing ceremonies for his sons little league teams, Fredo wanted to make sure he made it on time. (Last I heard, I think he did)
As always, Cristina was there supporting her older brother.
His Dad Victor was there comforting Daniel and providing his son with some words of encouragement.
There is a high possibility that Daniel will be moved to Medical ICU in the third floor tonight.
(Trying to step in for Sal, key word trying)
Today's Support Crew:
Margarita & Victor
John and Elena Escobedo
Jennifer & Jim
Thursday, June 11, 2009
Sal lives by example; he is a mentor and a friend.
I thank Sal for his dedication to Daniel, our family and our web-log community, his committment to excellence and accuracy...and for his creativity. I love the roll call with revolutionaries, and the digs at the insurance companies and private health care. Sal has written about Daniel's health--always hopeful--detailing his progress and care. He has done this all in honor of Daniel, on our behalf. Sal is "returning to his life" in San Felipe for a spell to tie up some loose ends before it gets too hot down there! Take care Sal! We'll see you and Tia when you get back!
Daniel had a relatively calm night. He is still running
a fever, temp. at 100. The heart fluctuations continue.
Dr. Sacks attributes both conditions to the brain trauma.
A chest x-ray taken early this morning shows that his
lungs are clear.
Daniel looks good this morning, he is breathing on his own
with ventilator assist. He is getting his morning sponge
bath at this moment. Sigue 'Calm, dark, and handsome'.
Some more physical therapy is scheduled for today.
Daniel's neurosurgeon, Dr. Tantuwaya, the SICU doctor, Dr.
Sacks, will confer with Cathy, Victor, and Margarita
tomorrow at 2:00 to discuss Daniel's condition, possible
options when his condition improves, and what the family
can expect as these next few days and weeks transpire. The
decision to transfer Daniel to Villa Pomerado will be made
once things stabilize here.
Daniel is still in room 208 here in SICU. Visiting hours are
stricter here than in the Progressive Care Unit. Visiting is
allowed from 8:30 am to 7:00 pm and from 8:30 pm to
Will try and update this later today.....
Daniel has been sitting now for about two hours and seems
to be handling the upright position very well. He sleeps,
then opens his eyes for 20 minutes then takes another
nap. It is 1:45 pm and Daniel is getting a hand and foot
massage by his Mom. Interestingly, Daniel's pulse will drop
from 1o5 to 87 while he is getting a massage. He is having a
nice peaceful day here with Margarita and Cristina. Will
put on some Marley for him while his eyes are open.
Take care of one another.....
John Escobedo ~ Chuy Miranda ~ Alfredo Vega (last night)
Margarita and Cristina ~ Cathy ~ Olaf Palme ~
Wednesday, June 10, 2009
Hope is not blind optimism.
It's not ignoring the enormity of the task ahead,
or the roadblocks that stand in our path.
It's not sitting on the sidelines or shirking from a fight.
Hope is that thing inside us that insists,
despite all the evidence to the contrary,
that something better awaits us if we have the courage
to reach for it, work for it, and fight for it. ~ Barack Obama
Good morning. Daniel is still here in SICU, room 208.
He has had better nights. Yesterday, the physical therapists
had him sitting up a little too long, given his condition from
the bout with ileus. This morning he was running a fever, 100,
and the fluctuating heart rate has returned.
Has gone 24 hours without vomiting. Daniel is receiving a
reduced amount of nutrients and is on the ventilator
for assistance in breathing. He is breathing on his own.
Yesterday afternoon he was starting to open his eyes again,
this morning he appears to be resting, recovering from
the long session sitting up. The doctor has detected pneumonia
and has prescribed anti-biotics which is being started
at this moment -10:20 am.
Daniel is also getting a dose of audio therapy by the Godfather
of Soul, James Brown! Our request to give our man a shave
was denied for awhile. Will ask again later.
The old drip tube of years gone by have been replaced
by electronic devices with digital readouts, electronically
adjustable rates in precise millilters per hour. Years ago I was
hospitalized and the practice then was for a nurse to adjust
this plastic clip and count the 'drips' using her wrist watch
to figure the amount per 30 seconds or per minute. Accurate
in those days, nothing like the precision of today. A small
commentary on how things have changed.
With the incredible detail of an MRI and CT scans 100 times
clearer than an x-ray, radiologists and neurosurgeons are
better able to treat patients, relieve pain and suffering,
and consequently save lives. The magnificent intersection
of mathematics, physics, chemistry, electronics, and medical
science. Fortunately, we are the beneficiaries of hundreds
of years of scientific research. Increasing survival rates of
cancer victims and restoring health to victims of brain truama
is the goal and worth the investment in research. The tragedy
is the billions or trillions spent on armaments and military
Take care of one another....
Oscar and Jessica Vega ~ El Nando Vega! ~ Marie Curie
Victor, Margarita and Cristina Vega ~ Luis Perez
Dawn-Super Nurse and her student Melanie
Jonas Salk ~
Tuesday, June 9, 2009
Whatever works for us as individuals to help cope with all these array of emotions, is what is “real” and “right” to us. As human beings on this planet we all have earned the right to choose the means by which we express our spirituality and there should be no judgment casted on anyone who differs from your own chosen method. Trust me; Daniel would not want it that way. Instead we should embrace and respect each other’s individuality and remind ourselves of our common goal; to provide our continual support and hope for Daniel’s recovery.
Daniel’s blog serves not only to keep us up to date with all the recent news of his condition, it also provides a therapeutic means for us to share our fond memories of Daniel, our bond with him, learning experiences with him, struggles we overcame together, his influence on our lives, or anything that ties us to him in some way. Whatever it may be, it is more than okay, because it comes from a place of love.
I highly encourage all of you to keep doing your vital part in this process, whether it is praying for Daniel to Allah, Buddha, Jesus Christ, Coatlicue (aka.. La Virgen de Guadalupe) etc… or reading scripture in the bible, Koran, or whatever it is you have chosen to believe in, please continue to keep Daniel in your thoughts and prayers. If you have contributed to Daniel’s blog, keep it coming, and if you have thought about it, but have yet to exercise your awesome blogging skills, don’t be hesitant, your words are just as important as the rest of ours. If you visit him daily, weekly, or monthly, just keep coming to see him whenever you can, everything we all do matters.
Jesus “Chuy” Miranda
Daniel had a tranquil evening, Cathy spent the night
on the sofa bed. The nurse reports that they
have the ileus under control. No more vomiting and they
continue the 'trickle' feed of nutrients. He is still having the
heart rate fluctuations but not in the range of the
previous days, the highest this time has been around 130.
Daniel's blood pressure is very good and things seem to be
returning to the stable condition he had prior to this episode.
Will post an update later today.
Take care of one another.......
(Monday and Tuesday)
Cathy, Victor, Margarita, and Cristina
Nando Vega ~ Victor Vega II ~ Adan Vega ~ Camilo Torres
Monday, June 8, 2009
Addendum to first post for June 8
Sorry for the delay in updating this morning's post.
The cause of the nausea and vomiting that caused the
move back to the SICU was diagnosed as a mild ileus.
Ileus is a condition where the bowel (intestine) doesn't
work correctly, this means the bowel doesn't contract
normally to force fluids and food (liquid nutrients in
Daniel's case) down the gut canal. In Daniel's case it is
some inactivity of the bowel, not an obstruction. There
are several possible causes of ileus, it is suspected that
this was brought about from continued use of medications
following the surgery. The main treatment of this condition
is to rest the intestine until it becomes active again. This
is accomplished by keeping the stomach empty. This helps
treat the nausea and vomiting. They stopped the nutrient
feeding for most of the day, but have gradually started to
reintroduce small quantities of this. The vomiting has
stopped and he is breathing easier and resting. He is tired
from the whole episode as you'd expect.
Another blood culture will be checked to head off any
infections. Blood sugar levels are at textbook levels, no
The labored breathing last night and early this morning
was related to the vomiting and now that has been cleared
up. He is breathing on his own and they are giving him an
assist with the ventilator.
The problem of controlling the amount of cerebro-spinal
fluid around the brain has been corrected. The neuro-
surgeon has been able to fine tune the existing shunt and
consequently will not need to replace it surgically.
It is a given that once the level of fluid is brought into line,
Daniel's brain will not be subjected to variations in pressure,
the ventricles will return to normal size. Daniel's
chances for regaining consciousnes will increase.
This is another challenge Daniel has endured and he appears
to have weathered this storm. For us, it is testing our
ability and strength to deal with the daily peaks and valleys.
But, it was said earlier, it is going to be a long journey and
we are up to the task at hand. With the super attentive care
he is receiving here and the promptness of treatment needed,
it is reassuring that Daniel is in the best possible environment.
One must marvel at the technological applications of chemistry,
physics, engineering, optics, imaging, electronics, micro-processors,
etc. to the field of medical sciences.
Take care of one another............
First and foremost, please don't be alarmed.
Daniel was moved from the Progressive Care Unit back to
the SICU early this morning, it may have been about
I conferred with the evening nurse, the day nurse, and
Dr. Sacks in SICU to determine the reasons for the move.
Daniel was experiencing labored breathing and nausea.
The nausea lead to vomiting. An indicator related to his
pulmonary status showed a low oxygen saturation rate.
A CT scan of Daniel's lungs and head were performed this
morning. The results of the lung scan was negative in several
areas. There was no inflammation. There were no blood clots.
Any secretions that Daniel had been coughing up have not
entered the lungs.
The result of the head scan have been sent electronically to
Daniel's neurosurgeon. The doctor is due in sometime this
morning. At that time he will determine if he will do a shunt
revision (possible replacement).
A blood panel/culture came back negative.
By all evaluations done this morning, the ICV filter is doing
Daniel looks like he is handling all this with the will he has
demonstrated over the last 41 days. Again, when you
consider all that he has endured, this guy is one strong cat.
He is showing everyone here another dimension of the
human spirit! Like he is telling all the medical staff that
if they do their job he'll give them 110% of all his heart and
We've all seen a display of the highest applications of medical
science. The use of computers prompting nurses to make
entries in a hundred different areas related to the patients
health. Electronic monitoring of vital signs, body chemistry,
and oxygen parameters. Electronic and computer metering
devices controlling medications, fluids, and nutrients in
precise micro increments- with zero failure rates. Pressure
devices with computer monitoring to control the pressure
boots on Daniel's feet and ankles- this in turn being part of
the effort to keep blood pressure levels at optimum levels
combined with medications. Then there is the hospital bed
with electronic and hydraulic instruments to keep the
patient in the most comfort position to promote healing.
All this high technology blending with the human element
of highly trained doctors, nurses, and technicians. Still, you
see the use of a flashlight, a stethoscope, and the human
intervention of listening, looking, and touching to see that
everything is working and in sync.
Will update this post before 2:00 pm.
Take care of one another...........
Sunday, June 7, 2009
My first encounter with Daniel was strange, but fitting considering the kingship our friendship is built upon. For some reason, which I can’t recall, Vega challenged Chuy Miranda, Jimmy Duarte, and myself to a wrestling match after our freshmen football practice by the high school plaza vending machines. Remember, we never met or talked to this undersized pretty boy—I guess our gladiator football armor did not impress him. In a matter a fact way, he proceeded to tell us how he could pin anyone of us in 15 seconds! Needless to say, Jimmy stepped up to the task and, yes, Daniel took out my good friend in under 15 seconds. We stood there contemplating whether we should “jump” this cocky kid, but Jimmy stood up and shook his hand. I must admit, Daniel would have been a hand full considering what he had just done, but his cousin Big Fern was also present—big dude for a Mexican back in the day. We figured these two cats would make better friends than enemies. And so this narrative began . . . .
Next stop: The Ranch. Way back when “The Ranch” was part of the Vega Trilogy Hill. Daniel, Pilon, and Fern’s parents owned the lower half of Startrek Lane. On Juanita’s property there was a nursery with plenty of ample space for us to roam and plot mischief. None of us owned a vehicle to get around at the time, so we christened the nursery “The Ranch” and our designated playground on weekends. Plenty of nights were filled with laughter, bonfires, and debauchery. Shoot, we have been known to assault discarded refrigerators and old broken down buses, pull classic “Stand by Me’s,” and faced the dear consequences of crudas: El Huevo!!! (ask the Boyz for definitions and explanations) Vows of camaraderie were taken on this natal ground and a sense of acceptance, loyalty, and identity was cultivated. Roll Dogz ever since—como mugre y uña as mom would say. Ironic, isn’t it, that our communal friendship has roots in a nursery.
Acceptance, loyalty, and a common cause/identity are attributes every young, first generation Chicano needs to somehow find in a country that has historically marginalized our culture, language, and history as a people. As young teenage rebels, we understood our subjugated existence within a school system intent on policing racial identities, limiting academic resources (assigned autoshop for math credit!), funneling brown bodies into Ivy (continuation school for at risk students), and exercising expulsion as the final remedy for “unruly” students. We understood this environment and retaliated the only way we knew how: questioned the established order at every turn. Teachers, counselors, principals, school boards—never had chance. Of course, some of us were funneled to Ivy, expelled, and bounced around to different school districts. But we managed. Survivors of a school system that produced one of the highest drop out rates in the county in 1993—second only to Oceanside High. Dark times to say the least, but no excuses. We never needed pity and never swam in a pool of apathy. Battle scars that’s all. These wounds, however, came with future accolades. This lowly circle of unruly, at risk youth has since produced 4 Bachelor degrees, four Master Degrees, one PhD, company administrative heads, and business contractors and owners. Not bad cabrones, not bad at all.
As you can see, we’re equipped to travel these hard roads, to take the long route to success. So Doc’s, please, don’t give me stats and percentages—don’t want to hear it. Just patch my Boy up and he will smooth out the edges and wrinkles. Vega does not accept failure and acquiesce is not in his nature, never has never will. We fight . . . he will rise, dust himself off, gives us his signature clap, and say “WHAT!”
So you take your time brother. Navigate these uncharted dark waters and find your way. Because, as a great Nuyorican poet once said, “The Sun Always Shines for the Cool.”
Walk Tall, Talk Big, and Live Strong.
Patience and fortitude conquer all things
Daniel's neurosurgeon has indicated that he
may need to replace the shunt valve unit as he has
not been able to achieve the fine tuning that he
wants. That was the word late Saturday, the surgeon
may come in today to speak with Cathy about this.
With Cathy's approval the surgeon may schedule
the surgery for tomorrow, Monday.
This will obviously affect the tentatively planned move
to Coronado Acute Center. As of this moment,
everything is on hold.
We've been playing James Brown greatest hits for
Daniel and some Nirvana. Daniel is hangin' in there,
he still opens his eyes and appears to nod off every
now and then. There is no physical therapy on the
Will follow up this post with more info, later today.
UPDATE: 7:20 pm Sunday
It appears the plan to surgically replace the shunt
has been changed. They will try to schedule the pro-
cedure for Tuesday or Wednesday. This means that
Daniel will more than likely be allowed to stay here at
Sharp until Friday. This is all tentative of course and
may change tomorrow.
Cathy ~ Dorothy Reina ~ Nancy Turner~
Irene Lopez ~ Nando, Sarah & Lola Vega
Alfredo & Diana, Alfredito, Diego Vega
Victor, Margarita & Cristina Vega ~ Nat Turner
Chuy Miranda ~ Andre (Surfs up- the Giant)
Hélder Câmara ~ Luis and Socorro Vega
Saturday, June 6, 2009
The days and nights pass. Daniel's neurosurgeon
watches and looks for signs of any slight change in his
responsiveness. There are moments when he has the
appearance of trying to discern what is being said or
who it is that is looking into his eyes. Like being
trapped in a dream that he wants to end but can't seem
to break through. He has been off sedative and pain
medication for approximately two weeks. He still
responds to the pressure stimuli on his finger or foot,
he moves his arm or leg in each instance.
Daniel has not had to deal with the myriad of things
that can affect a sedentary existence. All organs are
functioning well. Except for the occasional fluctuating
heart rate, his blood pressure is good and his pulse
ranges from the low 70's up to the 90's. His color
remains good and he still has the ability to open his
eyes frequently. We're hoping that this period of
relative stability is providing the optimum conditions
for even the slightest response that will open the
door to eventual consciousness.
Daniel is still here at Sharp and should be here on
Monday. However, it looks like he will be transferred
to the Coronado Acute Care facility late Monday or
early Tuesday. Cathy and Margarita have visited
that center and several others that have been approved
by the insurance company. The Villa Pomerado option
is still on the table pending an opening. Daniel is on a
wait list there.
Chuy Miranda brought plenty of CD's with a variety of
music that will reach into the recesses of Daniel's
Take care of one another......
Cathy ~ Danielito ~ Nayeli ~Nando, Sarah, and Lola Vega
John Reed ~Victor y Carmen ~ Adan ~ Ariana ~ Anahi Vega
Griselda y Rick Nelson ~ Frederick Douglas ~
Friday, June 5, 2009
Good morning. Daniel had another peaceful night.
His vital signs are holding right in normal ranges. This
morning several physical therapists came in to assess
limits of movement, ability to sit up on edge of bed, and
the need for greater frequency of PT. The plan for today
is to get him sitting in the special chair for an hour or more.
Another CT scan of the head is scheduled for this morning.
This is to determine or measure the pressure caused by
cerebro-spinal fluid, the result will indicate if the shunt is
correctly adjusted. Achieving the correct amount of pressure
will affect Daniel's responsiveness positively.
Daniel can still open his eyes and looks good under the
circumstances. 'Calm, dark, and handsome.'
He is absorbing the Marley vibes all day. Time for some
variety.....maybe Santana, War, Manu Chao, or RATM.
Whatever you want to bring, someone will make sure
it soothes his mind and body with healing rhythms.
Short comment on all the TLC that has filled Daniel's
cup to overflowing. We've been here to observe all the
love showered on Danielito's hero. I can only mention a
few anecdotes as any attempt to include the infinite acts
of love would be impossible. Friends and family
massaging his hands-arms-toes, cousins applying lip
gloss, friends damping the perspiration off his brow,
brothers adjusting the wrist & hand braces, uncles
giving him a shave, songs from a brother, a manicure,
nephews/nieces holding his hand with tears of love,
encouraging words from co-workers to fight on,
Tia keeping the nurses alert to linen, hoses, strange
Cathy, Victor and Margarita can see and feel the depth
of love and support given by all that have the time to
make the trip down here. From afar, they are moved
by the the cards, hopes, prayers, emails, contributions,
and concern expressed for Daniell and his family.
Messages from Dublin, CA and as far south as Colombia.
The expected move to one of several acute nursing
facilities is still to be determined. Cathy & Margarita have
almost exhausted all options to keep Daniel here at
Sharp. They are dealing with one of the many injustices
of a profit driven health care system.
Coincidentally, health care corporations and lobbyists are
holding their annual convention this week here in San Diego.
Protesters are outside the convention center calling for
replacing the private insurance market with a single-payer
system similar to England, France, Canada, & other European
Daniel has just returned from his CT scan. The results may
be available as early as this afternoon. Will keep you
UPDATE: 2:15 pm, Friday. The radiologist has read the
CT scan and has reported that there has been no change
from the last scan. The pressure reading will be given to
Daniel's neurosurgeon to decide if the shunt should be
adjusted, he is fine tuning it to give Daniel the optimum
conditions for regaining consciousness.
Take care of one another.....
Victor and Alfredo Vega (late last night) ~ Cathy
Jackie Wilson ~ Oscar Vega aka Pilon ~ Victor Vega Sr.
Luis and Rosa Vega ~ Simón Bolívar ~ Pat Savas
Thursday, June 4, 2009
Hope never abandons you, you abandon it. ~George Weinberg
Daniel had another restful and tranquil night. He has
his eyes wide open and looks good. 'Calm, dark, and
handsome'. Similar problems with fluctuating
heart rate, but the nurses give him a small dose of
medication to stabilize. This morning the two day
shift nurses, Ian and Donna, came in to rotate Daniels
position and evaluate his vital signs. We had Bob Marley's
Legend album playing, when they came in their reaction
was 'Hey cool, the only way to work'. Big Fern, Sarah,
and Fern Dawg brought a CD player with speakers
yesterday afternoon and of course the custom Marley CD.
I placed one speaker on the bed, so Daniel's audio/stimuli
this morning started with 'Don't Worry'! Thanks to Fern
and family, they responded to the request faster than
UPS! Also, thanks to other friends and family that
offered equipment. If anyone has other CD's, feel free to
bring 'em down. Remember, Daniel has the Legend album
Daniel has been receiving a pulmonary treatment called
a 'Bi-Level Positive Airway Pressure'. This keeps the lungs
pressurized at normal levels. Patients with traches tend to
have shallow breathing patterns. This treatment helps to
expand the lungs.
A colleague of Daniel at the Norco campus of Riverside
Community College visited Daniel most of the morning
and afternoon. David Payan offered that faculty and students
miss Daniel dearly. An Aztec dance troupe performing for
an event on campus dedicated and offered a special dance
to Daniel and a complete recovery so that he may return
Victor, Margarita and Cristina Vega ~ Irene Lopez
Digna Ochoa ~ David Payan ~ Gregorio Cortez ~
Big Fern Vega ~ Jon Jon Gonzalez ~ Oliver Tambo
Oscar Vega aka Pilon
Wednesday, June 3, 2009
Well, the word is Daniel's insurance company has insisted on transferring him to the El Cajon acute care facility. The transfer date may be tomorrow or Friday. Cathy tried her best to keep her man at Sharp, to no avail. There may be a chance that an opening will be available at Villa Pomerado earlier than two weeks. Daniel's name is number one on the 'wait list'. We'll do whatever we can to assist Cathy during this transition. Health insurance companies make mindless decisions based on 'cost analysis'. Profits over people!!
Some see a hopeless end,
while others see an endless hope. ~Author Unknown
Help. Continuing the effort to provide audio stimuli,
it would be nice if someone had a spare portable
CD player, or one of those real small players that have
programmed music. We'd like to play some
music or voice recordings during those times when
visitors are at a minimum. I know he enjoys reggae,
Bob Marley, Big Mountain, Burning Spear, Peter Tosh,
Jimmy Cliff, etc.
Could you contact Victor Vega via email if you can help:
He can't use those head phones that go over the top of his
head, if you have the small light weight in-the-ear type, those
would work best. Thanks
Once again Daniel is hangin' in there. His eyes were wide
open and he actually appeared to look to the side slightly.
Both eyes seemed to track together which is something
we haven't seen. His doctor was in late yesterday and
tried audio stimuli by yelling "Daniel ! Stick out
your tongue"! Those of us in the room detected some head
movement in the direction of the doctor. Like he was
turning his head in the direction of the sound.
Daniel had a tranquil night and he was being prepped for
the IVC filter procedure, he should be back by 9:30.
There are medical theories on Coma Arousal Therapy
that are being researched with mixed results. The studies
are testing stimuli to the five senses: vision, hearing, touch,
taste, and smell. One study focused on the effects
of family and friends speaking to the patient often. The
study emphasized frequency, intensity and duration of the
stimuli. The results obviously are different with each patient.
Nevertheless, Daniel's support group is here, we have the
numbers, the patience, and the determination. Si se puede!
The family urges all of you to talk with him, read to him
(poetry-song lyrics-sporting stories-psalms-bible verses)
sing to him (Marley verses), reminisce about good times,
adventures and even misadventures. The Choir Boys know
what I am talking about.
Thank you for your efforts in this area. A true labor of love!
Will hear sometime today if Cathy's valiant efforts are
successful. As you know, Daniel's health insurance company
wants him transferred to Villa Pomerado ASAP, but a room
won't be available there for two weeks. Their solution is
two transfers, one to a facility in El Cajon for two weeks,
then, if a room is available, a transfer to Villa Pomerado.
You would think that in the best interest of Daniel's health
the rationale would be to just keep him here until he can be
transferred to Villa Pomerado. Last night, Victor Sr. and
I counted 10 empty rooms on the 4th floor, the Progressive
Care Unit. The night before it was 15 empty rooms.
What's wrong with this picture? Let's see, 10 rooms here,
no rooms over there......hmmm. Our patient needs acute care
and Sharp is an acute care facility..........lets just wait.
It comes down to the cost differential in the rooms and
the insurance company's drive to minimize expenses and
maximize profits for share holders. Again, profits over people.
Victor Vega II (last night)
Cathy, Michelle ~ Robert and Olga Chavez ~ Rudy & Ruben
Aguilar ~ 'Nando Vega ~ Benigno Aquino ~ Chuy Miranda
Võ Nguyên Giáp ~ Big Fern Vega & Sarah~Fern Dawg~Julianna
Victor ~ Margarita ~ and Cristina Vega
Tuesday, June 2, 2009
Daniel's vital signs are stable and the heart rate fluctuations
are under control.
The doctor that ordered the sonogram of Daniel's legs
has recommended placing a small filter in a vein to stop
potential clots from traveling to the heart and lungs.
Due to the immobility of Daniels legs he is at risk of
developing a blood clot in those extremities. The filter
can be installed in 15 min. through a catheter inserted
near the groin. The vein is called the Inferior Vena Cava
and is located in the abdomen (stomach). This vein brings
blood from the lower parts of the body back to the heart.
The filter helps prevent the blood clots from blocking blood
vessels in your lungs and causing serious problems.
The procedure will be done tomorrow morning.
Daniel's health insurance company has decided that he
must be transferred to an acute nursing facility as soon
as possible. This could be as early as this Friday.
The current floor that he is on is an acute care level,
but he cannot stay here. The original plan was to transfer
him to Villa Pomerado Acute care facility next to Pomerando
Hospital in Poway. They have informed Cathy that there will
be no bed available for two weeks. There is the possibility
that he may have to go to an acute care facility in El Cajon
for two weeks. Cathy has been on the phone all day with case
managers, social workers, Greybill medical, and others
trying to keep Daniel here or find a temporary facility
closer to Fallbrook or Valley Center.
Health care in the U.S.! ......... Frustrating and irritating.
Profits before people. So many bureaucracies and levels
to deal with- insurance companies, HMO's, hospitals,
doctors, pharmaceutical companies, employee benefit plans,
funtionaries deciding who lives or dies...........
Dante would definitely have a circle in hades for all this
mindless inhumanity in his Divine Comedy!
Take care of one another.......
Cathy, Victor & Margarita and Cristina Vega
Adrian Gonzalez ~ Lito Jimenez ~ Mercedes Sosa
Raul & Yolanda Vega ~ Raul Vega III ~ Chuy Miranda
Leonard Peltier ~ Aida Barradas ~ Sylvia Abdala
Juanita Vega ~ Juanita's sister -Sylvia ~Jacobo Arbenz
Dear RCC-Norco and Riverside Community College District,
There might be some misinformation about this, so I would like to clarify the following: The Riverside Community College District has not severed Daniel’s contract, on the contrary the RCCD family are contributing their sick time to Daniel. The sick time from RCCD faculty is being accrued by Human Resources and placed in for Daniel to use.
I am deeply grateful to all of the caring people at the RCC-Norco Campus and the Riverside Community College District who have assisted me with Daniel’s employment situation, and who have generously donated their sick time to Daniel.
I want you to know that Olivia, Danielito, Nayelli, and I, are deeply touched by all of your well wishes and donations. All of you, along with the many other people who have made donations to our family, are making it possible for us to continue to care for Daniel, rather than having to focus on our finances, during this difficult time for our family. I know Daniel would be absolutely amazed and ever so grateful by everything all of you, are doing for us.
Hope is necessary in every condition.
The miseries of poverty, sickness and captivity would,
without this comfort, be insupportable.
~ Samuel Johnson
A little late with this morning's update.
Daniel continues to have fair to good evenings, last night
he experienced another episode of fluctuating heart rates. It
was stabilized with some medication called LoPressa. Again,
he looks good ~ 'calm, dark and handsome'. They took a
sonogram of his legs to make sure he had no blood clots. The
result was negative- no clots. His blood pressure is good-
115 over 63 (better than my bp). Body temp one degree
above normal. Nurses check blood sugar several times a day-
this morning it was excellent - no insulin needed.
A reminder of the Glasgow Coma Scale - Daniel is evaluated
at least four times a day to determine any progress or
regression. His evaluation yields a score of 8 one day and 9 the
next. We're relieved that it hasn't fallen below 8. Hoping for the
day it gets up to 12 or full consciousness which is 15.
Stay tuned, I will update this later this evening.
Cathy, Victory& Magarita and Cristina, Chuy Miranda
Oscar Vega (Chula Vista) ~ Oscar Romero ~
Raul & Yolanda Vega ~ Raul Vega III ~
Monday, June 1, 2009
It is 9:00 am and although Daniel had a difficult day
yesterday with elevated heart rates and fever, it appears
his heart rate has returned to normal and the fever has
declined. His neurosurgeon was in yesterday to adjust the
shunt flow to stabilize the accumulation of cerebro-spinal
fluid near the brain. This does not require surgery. The
shunt is under the skin and can be adjusted by placing an
electronic remote near the device. High tech. Daniel's
nurse just reported that he had another episode of heart
rate fluctuations last night, but it is under control this
morning. Also, Daniel's neurosurgeon is coming in this
morning to make another small adjustment on the shunt.
Daniel looks normal in the sense that he looks like he is
taking a short nap. He is still unconscious. His eyes are wide
open this morning and appear normal. He blinks a lot, then
gives a pretty healthy yawn.
If I may speak for all that were here yesterday, we were
apprehensive about the high heart rate, the fever, and the
feeling that Daniel was not tranquil and was not having the
best of days since leaving the SICU. We are waiting for the
pulmonary specialist to come in this morning to ask him/her
about Daniel's symptoms of bronchitis. Very relieved this
morning that all his vital signs are back to normal.
Will post more info later. Well, June gloom is here. Heavy
marine layer, result of the cold ocean current.
Take care of one another......
Victor, Margarita, and Cristina Vega ~ Cathy ~
Luis Vega Sr. ~ Luisito Vega ~ Chano Rodriguez