Valentine’s Day is when my husband Casey had his brain bleed. I spent 17 days with him in the Neuro ICU at KU Med Center. I shared what was happening on my social media feed, and I also kept a private set of notes throughout so I could share the gritty details with Casey someday if he wanted to hear them. About a week into our stay at KU Med, I wrote this little narrative about him, but I never shared it. Today (Valentine’s Day) is a great day for that, because it’s a bit of a love letter using photos from his phone. I’ve added my Aneurysm Diary afterward and added photos from that time. It’s a story of how 2021 changed the course of our lives and my business. Some of the details of the aneurysm and its warning signs are a little embarrassing, so forgive me, because if you take anything away from it, I hope it’s how to better recognize when someone is having or has had a stroke.
How we met…
When friends introduced us at a party on New Years 2014, Casey McGuire was intoduced to me as Farmer. We hit it right off and began talking after he friend-requested me on Facebook and began messaging me there. Our first date was the two of us demolishing the wall between the two tiny bathrooms in my house. When we played the who-do-you-know game, we realized we had tons of friends in common. When I was in high school, I was friends with peers from many other towns, including his, so I was surprised to learn Casey was less than a year younger than me, from nearby Lockwood, and we had lots of the same friends but we had never met each other before. When I had surgery on my knee that winter, he took care of my cattle for me through some really nasty weather conditions. The first time he said I Love You, it was in a room full of my people. That’s when I knew he was pretty much fearless. He’s also very talented and meticulous in his work. When plans change it kindof throws him in a tailspin, so he’s pretty tough for putting up with us gals, as we like to fly by the seat.
He built this log splitter himself from his own design.
He loves taking care of us. Check out his woodpile pics.
He also loves some tractor time.
Did I mention he loves to split wood?
He works at Redneck Outdoor Products. Before the aneurysm, he loaded trailers with deer blinds. Now, he packs and ships all the UPS orders.
He built his own truck from the parts of three others. Here it is loaded with wood last fall.
He loves to take funny pictures of our animals.
He keeps screenshots of my art to show other people on his phone.
He stops mowing hay to take pictures of rainbows.
He loves our girls a lot.
He takes an excellent sunset pic from the front porch.
We make a pretty good team.
I have never doubted for a second that he adores me.
He baled that.
Sunday, February 14
Casey said he had a headache. We spent the day inside because of snow/ice. Temps were in the single digits.
He had done chores the day before and also broke ice Sunday.
Sunday evening I thanked him for doing all of the chores so the girls and I could stay in during the bitter cold.
Creek had been in her phone a lot that day, but I hadn’t had an issue with it. She had helped me with the kitchen and tidying up around the house, and was at the kithen counter, doing some arts and crafts with Cale, when Casey jumped alllll over her for not helping with chores and just sitting around with her phone all day. I was in the bedroom, working on some earrings, when she came in and handed me her phone with tears in her eyes. I asked what was up and she said Dad told her she didn’t need it anymore today. I received it from her and said come on, let’s see what’s up. I asked him why she was in trouble and it basically fleshed out to he was just irritable, because when I pressed for why, he really couldn’t tell me. I explained to him that I had allowed her to have the phone for the day, that I had loosened her screen time restricitons for the day, and that I had thanked him for doing the chores for all of us and there was no reason for him to be on her ass about it. I said the girls are sitting here together with craft materials, and they’re getting along, so I don’t understand why you’re rocking the boat, and I walked away in tears myself, confused to why he was so upset with her. It’s like he didn’t even remember the acknowledgement that I had given him. It was really confusing and made me so sad. He had been really irritable lately, but not to the point of picking on anyone. Twenty minutes later it was like it never happened. He was in the bedroom, peering over my shoulder at the earrings I was working on at my desk. This was weird behavior too, like he couldn’t find anything to do and was just intent on what I was doing. He did it several times that day. Like he was a little lost.
Monday, February 15
4:45 am—I woke to Casey making grunting animal sounds in the living room. Grunting, coughing, straining. I got up and went in there. He was squatted on the floor, kind of rocking back and forth on the balls of his feet, and as he rocked back, he would hold his hands up in front of him in frustration, then throw them up in the air and grunt in agony, gesturing with both hands like an angry Italian. He had soiled his nightshorts. He was able to tell me that he had, but he acted like he didn’t know what to do next. I asked if I could help him and he nodded. I got him a towel and told him how to wrap it around himself and walk. He headed for the bathroom , and I heard the shower turn on. I got cleaning supplies and went and cleaned the carpet. There was also vomit on the floor. It looked like he had simply lost control of his body functions.
When he got out of the shower his alarm began going off on his phone. 5:15 am. I wasn’t done cleaning yet, so I asked him if he could shut his alarm off.
After I was done, I tossed the cleaning towels in the washer with the rest of the mess and went to check on him. He was sitting on the bed with his phone, scrolling the social media. I asked him what had happened in there. He said he got up with a headache in the back of his head and his neck and sholders. He said there was something fuzzy in his right eye. I said I don’t think you should go to work. He added that he got up with the headache and went and sat in my chair. He got up to go to the bathroom, coughed, and doesn’t remember anything after that.
He said he was going back to sleep. I went to my chair. At 7 am, he came to the living room and asked me if I had heard his alarm go off. I told him he turned it off himself before going back to bed after his shower. He was confused and it seemed he didn’t remember any of what happened. He got dressed and went to work.
As he pulled out the drive, I called his friend and coworker, Jeremy, and swore him to secrecy about what happened and asked him to keep an eye on Casey and let me know if he did anything strange.
After work, he came home and crashed after checking the woodstove, approximately 4:30.
At 8:30, he woke up, still with the headache. He ate dinner and went back to bed.
Tuesday, February 16
4:40 am—I woke to him rearranging the contents of his night stand. He would move the Mt. Dew cans and rifle through his change pile, like he was looking for something. Then he moved the metal folding chair that was leaning against the bedroom wall. Clink clunk. Moved it again. Stomped on the floor. Took a couple heavy steps. Stomped again.
I asked what he was doing and he said something about his leg hurting.
He got ready for work after his alarm went off at 5:15, then kissed me bye. I asked how he felt and he said he still had a headache.
I did all the chores that day so he could just relax afer work.
The temperatures were so cold my parents’ vehicles wouldn’t start. I had brought Mom to our house so she could use the wifi, and after Casey got home at 4:30 and checked the stove, he went and crashed. I took mom back home, and I told her during the short trip what was happeneing with Casey. She said that doesn’t sound good at all and told me I should call Jeremy and see how Casey acted today. On my way back to the house I called him.
He said Casey had gone out to get a truck and trailer to bring in the warehouse and he didn’t return. Mikey went to get it 45 minutes later and found Casey asleep in the truck.
When they were done for the day, they all clocked out and when Tommy went to lock up, he found Casey asleep on a pallet of boxes. They woke him and he was confused, but he got in the truck and came home.
He woke around 8:30 pm, ate dinner, had a shower and went back to bed.
Wednesday, February 17
No sleepwalking today. Kissed me good-bye and I got up to work on jewelry on my desk in the bedroom. He came back shortly after. He said his vision was worse and he had to turn around at the blacktop and come back home. We had another fresh snowfall, and all the tire tracks and the blacktop were covered again. He said the moon’s reflection on the snow made it really bright and it was hard to tell where the ditch was at.
I asked him if he remembered Monday or Tuesday morning and related what his behavior had been. He didn’t remember any of it.
I put all the happenings together and told him I thought he had had a stroke and we needed to get to the doctor. He thought he needed to go to the chiropractor, but the chiro was out of the office until Friday. “My back is just out.” I assured him that this was more than just a chiropractic issue. I called my mom to double team him, and while he was irritated and defensive, having her say it too helped, and he consented to calling the doctor.
When 8 am rolled around, we called the clinic at our local hospital. We were able to make an appointment for 2:15.
I left everyone at home, got in the hay truck and went to town. I stabbed a big round hay bale on the spikes, a thousand pounds to give me plenty of traction. Everything and every school was closed because road conditions were awful. I needed to make sure the pipes were still thawed at my studio, and the hay truck needed fuel. I got those things done and wanted to give myself plenty of time to get home to pick up Casey. I went to Mom and Dad’s and started Mom’s car. It had been dead the day before and I had put the battery charger on it and boosted it to start it. It started, sluggishly, and I left it running and used the bale on the back of the GMC to push the drifted snow from in front of the barn across the road and into the ditch. I raised and lowered the bale to push the snow several times, and I had cleared it to where Mom could get the car out, and I went to the house to tell mom that I had left her car running and she neded to shut it off after bit. I shut the truck off to go into the house and talk to her, which was a mistake. When I got back in to go home and get ready for Casey’s appointment, the truck wouldn’t turn over. I had ran the battery down pushing snow. So I took Mom’s car. I was able to make it to our house, since she has all wheel drive, but making it into our driveway was a trick…there was a mound of snow there, so I got up plenty of momentum and slid across it, then was home free to get the half mile up the driveway. Casey and I left plenty early for his appointment. He leaned the seat back and never opened his eyes all the way to town.
We called the clinic when we got there because COVID restrictions prevented us from walking in unannounced, and even though we were 30 minutes early, they let us come in and put us in a room. They checked Casey’s blood pressure and it was 170/110 or somewhere thereabouts. They gave him medication to lower it, left us for about 20 minutes, then came back to check it again. It was 210/110. They put him in a chair and wheeled him to the ER, where he had a CT scan immediately. The doctor could see the brain bleed in the scan.
By then it was about 3:00, and they began looking for another hospital for him to go to. Freeman and Mercy at Joplin were both full. Cox South at Springfield had admitted a patient exactly like Casey, and their resources were committed to that patient. After 2 hours of waiting, they had a bed waiting for Casey at KU Med Center in Kansas City. Barton County Ambulance came to transport him, and I flew home to grab some clothes and toiletries and kiss my girls and get back on the road. The main roads were good and clear, but 126 highway and our blacktop were still covered in ice and snow. Our gravel road was barely passable in Mom’s car.
My cousin Phillip had lent Mom one of his pickups to drive until she could get Dad’s truck running, and she had brought the girls up to see me off to KC. I explained to them what was happening. Creek was very upset. I told her we were going to one of the best hospitals in the entire country, and I had already heard stellar things about the head of neurosurgery there. When I left home, I was an hour behind Casey.
When I arrived at KU Med, I Forrest Gumped my way to the correct building and parked in the garage, then I had to inquire as to where he was. When I got to his room, he was lying in bed with his eyes closed. Abbie, a neuro ICU nurse, told me what they saw on his scan. I asked to see it and she pulled it up on the computer. She showed me the pooled blood and told me he would have surgery first thing in the morning and would be here for a minimum of two weeks.
Word really travels fast. By the time I got to KU Medical Center, I had lots of supportive messages in my inbox from folks we love. I appreciate it so much. I know your prayers are working already because I have been able to stay so calm and take in the information from the critical care team and the resident on duty.
Casey has an aneurysmal subarachnoid hemorrhage, and will have surgery to correct it first thing in the morning.
This was caused by unchecked diabetes and high blood pressure.
He undergoes two procedures first. They will go in through the groin and insert dye to see how to proceed, then they may use coils to seclude the aneurysm (they know exactly where it is), and they will also do an EVD (external ventricular drain) in his skull above his forehead on the right side to drain off the excess fluid and blood in his brain. If these two procedures together don’t produce results, they’ll do a craniotomy, wherein they do a large round incision above his left temple, remove a round section of the skull and work from there to stop the bleeding by clipping it off. Possible seizures, stroke, sensory loss.
I have heard “You’ve survived an aneurysm, so you’re doing pretty good.” and “He looks really good for having a brain bleed 3 days ago.” So as you already know, he’s one tough son.
I appreciate you all so very much. Please pray tonight specifically for his comfort through the night. He keeps asking for pain meds for the headache, and he is really thirsty, but can’t drink or eat anything of course before morning.
Tomorrow, please pray for a good outcome, for elimination of the bleeding, for seclusion of the aneurysm, and for the EVD to not become clogged.
We will be here for a minimum of two weeks.
Thursday February 18
We had a roomful of neuro doctors and interns just before 7. They will come get him soon to perform the angio procedure to attempt to block off the aneurysm and place the EVD.
This is so enormous and hard and I feel alone, but I know I’m not. My phone was full of loving messages when I woke.
Casey is sleeping right now, but he was awake to talk to the team and was ALL ABOUT the talk of relieving pressure inside his brain. He is his normal punchy smarta$$y potty mouth self, just a really sedated version, which is a good thing right now. It won’t be easy to keep him here for two weeks. Right now he’s just exhausted and snags bits of sleep when he isn’t being poked at.
Keep the prayers and wonderful vibes headed our way. Be specific when asking our Father to watch over Casey. Ask him for the skill and precision necessary to block off the aneurism so that Casey doesn’t have to have the craniotomy procedure. Ask him for the EVD to properly drain the fluid causing the pressure and for it to function properly and not become clogged. Ask for Casey’s vision to be restored with the pressure release and for minimal damage to the optic nerve.
HE IS OUT AND DOING GREAT!
We’ll be here for 10 days-2.5 weeks, and he will be off work for 3 months.
Me: “I think they’re done poking around for awhile. Can I do anything for you?”
Farmer: “YOU can poke around on me for a little while.” *grins with eyes closed*
I think he’s gonna be all right.🤷♀️
FRIDAY MORNING UPDATE
Casey is doing good, but he tried to pull his drain out while I was making my bed up last night. The nurse replaced the bandage and put mitten restraints on him, which really irritated him. I rolled the chair next to the bed and put my hand on his arm, which calmed him, and I slept there until he settled and snored. I went back to my bed, but returned to the chair and holding his hand at 4 am when I woke to the nurse talking to him bc he had removed the mittens with his teeth.
He was coherent at 6 am, I would almost say sharp, but when the doctor did rounds at 7, he couldn’t answer all their questions (the same every time: what’s your name, what’s your birthday, where are you at, why are you here) and would barely open his eyes.
Nutrition came round just a little while ago. He only ate one square of potatoes and wouldn’t eat any more. I fed him half of an oats n honey granola wafer and he drank a small bottle of water.
As I was leaving Cox Barton County Hospital on Wednesday evening, I was carrying Casey’s clothes and boots along with my book, phone and paperwork from the hospital. I dropped my phone under the car and backed over it. I was almost out of the parking lot when I realized I didn’t have it and went back and got it. It still works but the screen is spiderwebbed in three places. My bff Liz, one rockin’ boss babe, is VP of Crossroads Courier, so she is sending a courier to pick my phone up from KU Med, take it to get a new screen, then return it to me. The phone leaves at 10 and I’ll be out of pocket till 1-ish. If you need me, hit me up on fb messenger. Liz is also sending a courier to get me some more things from home via my mom at the courthouse. She is so amazing and I love her so much, not bc she can make things happen, but bc she wants to.
Thanks again y’all. Your words of support are fuel for me. I’ve been reading them to Casey when he’s lucid.
SATURDAY NOON Feb 20
He refused to look at me or give a thumbs up or smile for a pic today. When I asked, he became intent on studying his drain tube.
He’s not happy that he can’t have a chew and he tore apart his nasal cannula last night and was chewing on it. I had to get the nurse on duty to help me get it out of his mouth. No more cannula. I got him gum yesterday and he has chewed it some but isn’t crazy about it.
He has had over 700 mL of cerebrospinal fluid drained off his brain through the external ventricular drain.
He tried again just now to remove the bandage and pull out the drain tube with his left hand, in a less-than-2-minute window when I wasn’t looking. I showed him again the picture that I took of the bandage and drain tube and explained what it is and the repurcussions for removing it.
His motor function is improving steadily. I hooked him up with some little beef jerky bites (won’t eat hardly anything), and he was using his right hand to get them to his mouth, which is an enormous improvement over yesterday, when he would hardly even lift the right arm. He lifted both legs from the hip last night for me and again this morning. I have been using oils on his feet to help calm his restless legs and to help his brain rest and heal, so I use that as an excuse to make him lift his legs up and bend the knees.
He is doing better at answering the questions. He nailed the month and year this morning during rounds, but still thinks we are at Cox Barton County, Pittsburg KS or Freeman Hospital in Joplin.
We are so blown away by the support from our tribe. You all are so wonderful and we love you so much we can’t even say.
SATURDAY PM—48 hrs post-op brain surgery
Casey stood and walked (with assistance) from the bed to the chair this afternoon and I gave him a bath, scrubbed the blood and iodine out of his hair, then combed and put his favorite oil on his beard.
He ate a chocolate pudding milkshake while I was bathing him, then he asked for his phone and opened fb and saw how amazing you all are.
There is something about bathing your favorite person…it is humbling in the best way. I felt a deeper love for him than ever before. I am so grateful he is alive. And it’s miraculous. My husband walked around for three days with an aneurysm and blood in his brain. It brings me to tears thinking about the signs that I saw and dismissed for fear of making him mad or embarrassed. That was one of the other signs I dismissed: he was really easily agitated with us. I need to journal about those days before I forget; I think it might help someone else see the signs and get their person help sooner than I did.
I need to ask for some specific prayers from you. Tomorrow, the 7-day mark from the initial bleed, we start a dangerous period. Days 7-14, there is a risk of vasostriction of the blood vessels in his brain that could cause a stroke.
Our brain is meant to hold cerebrospinal fluid, not blood.
What it reminds me of is getting radiator fluid in a truck transmission. The water eats the seals in the transmission that are only meant to be surrounded by tranny fluid. It causes damage that is only repaired by an expensive rebuild.
The blood that was released into the brain by the aneurysm, as it degrades, it can make the healthy blood vessels in there constrict, especially the ones surrounding the initial bleed where they inserted the coils. If they constrict too much, it can cause a stroke. The blood floating around in the spinal column will irritate the nerves there and cause a lot of pain as well.
They have started his medication to prevent this; however, I need you to pray for the medication to do its work, for the blood vessels in his brain to stay relaxed, for Casey to be patient with his body and go slowly as he stands and walks more in his rehab.
I can’t turn my back on him for a second. He’s like a precocious toddler. Pray for patience and empathy for me.
As I was working on typing this up, he tried to stand up from the chair on his own, which is a big no-no with that drain attached to his skull. It has to be shut off first. Also, if he falls, it could kill him. I got him sat back down and called the nurse and we belted him and shut off the drain and walked to the door, then back to the chair. So, 30 feet of progress. Yay! He got a little agitated at the turnaround point, maybe because he realized how limited he is at this time. There is no PT team here this weekend, so we think they’ll be blown away with what a stud he is on Monday.
Today we napped together, laughed together, yelled at each other (almost…it’s hard to keep my voice down when I turn my back for a sec, then turn back to see his bare ass trying to stand up without assistance, gown flopped open and EVD line trailing from his skull), I cried with my head in his lap (effectively blocking him from trying to stand) and told him he was a walking miracle and I am so so grateful he is alive. I said “quit screwing with the knobs on your drain!” He said “quit yelling at me!” Sigh. We got this. I have to talk very softly all the time or he thinks I’m yelling.
Earlier in the day, I had gone on an exercise walk, exploring the hospital and trying to work up a sweat because I hadn’t exercised in over 3 days and I wanted to feel those happy endorphins. The gift shop in the tower is closed today, but I found the main gift shop after crossing the skywalk from the tower to the main hospital. I wanted to find a journal to start recording from last Sunday when Casey’s behavior began to change. I found one, and I also found a beautiful memory game. I thought it might be fun to play memory, and if he didn’t like it, the girls would.
I unwrapped it after I returned just to see how pretty the art is on the tiles. I laid it out on the table and he began flipping the tiles and matching them up. So we played with em for awhile. They are really pretty and I love the sound they make when we flip them over. It took a little practice, but he was flipping them with his right hand really well. We didn’t exactly follow the rules, but whatevs. It was fun.
He ate really well for dinner! The first good amount I have seen him eat since surgery. Then he fell asleep over his tray. Busy day. But he didn’t want to go to bed…we took a walk down the hall and back, like 300 ft or so! Nurse Meghan and I both held the belt and he walked really well. Then he was ready for bed. We helped him stand at the sink and he brushed his own teeth.
He had an “extended clamping period” there with the drain shut off while we walked and brushed. After we settled him into bed, we opened the drain and quite a bit of fluid came off. He is resting now and so am I.
It has been a busy day with little down time to string beads. You know me; I can’t NOT bring work with me, so I chose the smallest thing possible: stringing tiny seed beads for my Farmgirl Hippy Boho Earrings and using my new beading loom. I can’t use the loom at night tho; my eyes don’t see that well up close anymore in dim light, so the loom is for daytime work. If I had a little clip light, I could prolly do the loomwork, but I can string the beads for the earrings in just about any light, so that’s what I’ll do this evening.
Thanks for following Casey’s recovery story, and don’t forget to hit up the Big Guy with those very specific prayers I talked about!
Much obliged and lots of love❤️
I have to keep a ridiculously close eye on Casey because he keeps messing with the drain in his skull. If he isn’t picking at the adhesive film over it or picking at the area where it’s stitched on, he’s resting his hand or forearm on it, and I’m on eggshells pulling his arm away and gently saying “stop messing with it,” so I asked him why he kept messing with it and asked if it felt better to put light pressure on it. He said yes, it feels good when he rests his hand on it. I said I brought your hat; what if I loosen it up and we put a washcloth under it on your head; that should put just the right amount of pressure on it and I won’t have to stand over you or rag on you about touching it and you might be able to rest. He said that’d be fine.
And he has been resting SO comfortably since then. He looks like he’s napping by the party pond on a Sunday afternoon. I felt silly for bringing the hat after I saw he had the drain in his head, but I figured he’d be happy to have it when it comes time to go home. I hope the neuro team lets me leave it on him; he is so much calmer now.
I only brought tall socks. When I was in the gift shop yesterday, I found footie socks half price. I absolutely love them, but I want to be able to wash them and hang them to dry, so I went to get another pair today. I needed to walk too. I ripped a muscle in my back while chopping ice for the cows last week, and while it doesn’t hurt at all while doing physical activity, it burns like fire at random times, like when I’m sitting still holding a book or the beading needle, or while I’m lying in bed. I can’t reach it to apply oils, so I’ve been living with it. No big deal. I just wanted a quick power walk to loosen up my back and to grab another pair of socks.
We had woken Casey to give him meds, and he was asleep again, snoring, when I asked the nurse at the desk outside our door to let our nurse know I left for a few minutes.
When I returned, the room was full of nurses. While I was gone, Casey had sat up in bed and pulled the EVD line apart, setting off alarms, I assume. He needed to go to the bathroom, which is great bc he needs to be going on his own, but immediately after he was done, he passed out, from a vasospasm, which is what we are trying so hard and praying so hard to avoid.
He’s ok. When I came in, they had gotten him into bed and were attaching restraints, which is another thing I have been trying very hard to avoid. Our nurse had no idea I had left. I don’t blame anyone but myself. Two nurses told me it can happen when I’m standing right there, especially in a patient like Casey who has no decision making capacity. He thinks he can do stuff, so he doesn’t think he needs to ask anyone for help, he won’t push the call button, hell, he won’t even call out for me when he needs something; I just pay really close attention and hardly let my eyes off him.
Our nurse got onto me for leaving. I asked if the other nurse had told her I ran out for a few minutes. Nope. No one knew where I was at. One point of defense, which I didn’t bring up, is that no one ever told me the rules. I have to tell someone anytime I leave the room. I thought this is why all the alarms. And I never thought he would try to sit up in bed and rip out the drain. Especially today. He has been totally listless and sleepy.
I held onto him until the neuro physician on duty got there. He looked at the EVD line, clamped off with a set of hemos, and said “No big deal.” Uh, ok…I watched him attach a new line from the break to the drain mechanism and tie a really tight suture on it. He reset the drain and primed it so that it immediately began pulling off fluid. He also ordered restraints. I asked him if he was going to explain that to Casey. He paused and leaned on the end of the bed and told Casey that we need to protect his brain and keep him safe, so he has to be in restraints for now.
Because he’s in the restraints, he’s pushing the limits and acting totally impulsive. I knew it would be like this if he ended up in restraints. Rather than just hang out with the wrist cuffs, which aren’t tight, he’s trying to untie them, trying to remove his heart monitor lines, and just being a nuisance in general, and I predict that he will be in even tighter restraints by nightfall.
All because I wanted a second pair of socks.
Now he won’t let me help him with anything and I’m seeing him turn on me. I tried to help him and he was rude to me, so I asked him not to be rude and he yelled at me that I haven’t seen rude yet. Time to just stay out of his line of fire and let the nurses deal with him.
MONDAY AM. Feb 22
Good report from the neuro team this morning. He was really alert for them.
The vasospasm yesterday changed his demeanor. He’s in restraints and I only talk to him when I think he might need help and the nurse isn’t nearby. It seems they are much quicker to react now when one of his alarms goes off.
I was able to tell him good morning and kiss his head, which was much cooler. His fever was 102.4 when I went to bed last night. They started him on antibiotics for infection yesterday. The infection could be from him peeling off the sterile dressing over his EVD site 3 times. He opened his eyes and said good morning back to me.
He’s in restraints now, which is another reason for me to step back and just be here. He asks me to remove them when I check on him, and then is agitated when I cannot.
The doctor took the time to talk to me alone for a minute after rounds. He said he looks really good. I could tell from his demeanor that he had been informed that I was pretty wrung out from yesterday. He said we are in that sensitive window for vasospasms right now and can see wide variance in attitude and behavior.
I said I get it, I’m doing ok with it, and I’m here if anyone needs me.
He asked the nurse yesterday if she was ready to go get her semi. She told him she doesn’t have one and asked if he does and he said no. Later he talked about the lemur jumping around grabbing the walls. She handled it in stride.
I caught her later and said his remarks may sound crazy, but they aren’t that bizarre to me, bc I used to have a semi when I was still farming crops and his best friend has a lemur that does in fact jump around and hang from the ceiling. His brain is just pulling random info and kicking it out in answer to questions.
Please pray for relaxation of the blood vessels in his brain, for Casey to not have any more vasospasms, and for the infection to be gone for good. Pray for him to eat something. I haven’t seen him eat since Saturday evening. He is always sleeping when they bring his meals, and my man likes hot food.
Thanks for all the good vibes; keep it up my friends!
Much obliged and lots of love💙
I needed everything to happen today just as it did.
I woke to the neuro team standing in the room, and they gave an excellent report and said everything is normal and looking good.
I typed the morning update and started my day.
I showered (with the same towel for the 4th time), prepared my backpack, got a peck and an I love you from Casey, and I went downstairs and had a sit-down breakfast while talking on the phone with my mama. She was headed to the feed store to get chicken feed, dog food and range cubes bc she is taking care of all our animals.
After breakfast, I went to Walmart nearby, mainly to get some hair conditioner and product. I came up here without the conditioner and ran out of product this morning, and you do NOT want to see my hair without product. Man, that Walmart was not laid out like the ones I am used to. It took me longer to find the things I went for that I planned. From the hair stuff aisle, I headed to look for stationery. I passed the home goods aisle, backed up, and got myself 2 sets of bath towel, hand towel and washcloths, so I would still have one set if I send one off to be laundered. Last thing was gel pens. I have been having a hard time concentrating on my work that I brought with me, so I wanted to be able to just do something that doesn’t require a lot of brain power, like coloring.
I had to look and look to find the pens. After I found them and tossed them in the cart, I looked at my watch, and overall, I had been gone way longer than I intended. This was supposed to be an in and out deal. Last time I left Casey’s room for longer than 10 minutes, he sat up in bed and pulled his EVD loose, which was scary as hell. I didn’t share that yesterday because it was probably the most raw experience I’ve ever had and I don’t really want to talk about it. I needed to get back.
I headed for the register and was halfway through checking out when my watch started vibrating. I glanced at it. KU Med Center. Oh God oh God oh God oh God…fumbling for my phone in my pockets…in that three seconds, a load of horrible possibilities flashed through my mind. I located the phone, whipped it out my pocket, fumbled it, almost threw it at the self-checkout screen, toggled the call on…my heart was pounding HARD. I answered calmly, “This is Angie,” expecting someone to say “this is Suzie from KU Med neuro ICU unit and your husband Casey has fallen and ripped his EVD from his head.” Instead, it was a nice lady from the business office. I calmly made an appointment for 1 pm to talk, then finished checking out.
I got outside and into the car, started it, backed out of my space, and as I shifted into drive, I guess my body recovered from what had just happened, and I suddenly felt every emotion I had felt inside at the register all at once: shock, big fear, panic, relief…and I panicked. I looked around and the parking lot spun. I couldn’t find the exit. My heart was pounding. I could hardly breathe. I pulled into a spot and called my mom. She too was at Walmart. We talked until I was calm enough to drive. She told me what she had been shopping for. I told her about the phone call. I cried hard. She told me “You are going to be taking this day by day, hour by hour, minute by minute, but remember, every little thing is gonna be all right.”
When I got back to the parking garage, every level was full except for the top. As I was gathering my things and locking up, my friend Vickie called. We hadn’t had a chance to talk in weeks. I rent space from her up here in KC’s West Bottoms, and we are friends with a lot of similarities. I got near the stairs and put down my things and rolled up my sleeves. I sat the phone down on speaker so I could still talk, and stood in the sun in mountain pose. Aside from stepping out the front door of tower A to grab food, laundry and money, I hadn’t been outside in over 4 days. I’m a sun creature. I get weird and moody if I don’t get some sun regularly. So there I stood, on top of the parking garage in mountain pose, exposing every square inch of skin I could stand (it was 40 degrees) to the sun. At this point I had been gone way too long and I ended my call with Vickie and headed to the neuro ICU, where Casey was still snoozing soundly.
Shortly after I returned, a man came to visit me. His job is to be an intermediary between the patient and the rehab facility and make sure Casey is getting the care he needs. He talked to me about our living arrangements, about rehab, about how we would get Casey back to being his old totally independent self, and he asked me how Casey’s aneurysm had presented itself to me. He said that was a seizure. I related the symptoms and told him I still felt guilty even though I know I shouldn’t for not getting him into a doctor two days earlier. He said it was EXTREMELY UNUSUAL presentation for an aneurysm, and told me once more that I shouldn’t feel bad about this. I said I know, it’s all just still so raw, so it makes me emotional, but I want to be able to relate this to others so they know that whatever it takes to get their loved one to a doctor when they act strange, whatever it takes, do it. He was in agony for three days, and I could have prevented some of that if I had just told him how he was acting and insisted on going to the doctor. I assumed he knew and just didn’t want to talk about it, but he had no idea bc he didn’t remember. We discussed where we will go after we are finished here at KU Med. He said there are great in-patient rehabs in Joplin and Springfield, and we will more than likely be able to be down there closer to home for that.
After he left, PT came in and got Casey on his feet.
It took a little while. He was really dizzy. At first he didn’t want to get up on his feet. Sitting was hard. His back hurt. They did some stretches where he put his ankle on his knee (unassisted!) and did some deep breathing as his muscles stretched, then swapped to the other leg. I thought it pretty amazing he could put his ankle on his knee. Then they stood him up. They got him a mask (I think just to get him accustomed to wearing one). They walked around the bed and over to the recliner and sat him down. The gal who was doing the heavy lifting was much smaller than Casey, but she knew her stuff. She shook her arms and took some deep breaths to recover from the exertion of getting him there, then they stood him up again and put an assistive sling under him before sitting him down again. We wouldn’t need the sling though…he stood on his own many times throughout the rest of the day and we never used it, just had to untangle the handles on the dang thang from the moving parts of the chair several times.
After that initial stand and move, he wanted to get up a LOT. I can’t get him up without someone in here with me though, as the EVD must be clamped off, the heart monitor unhooked, and the rolling IV stand must come along with us where we go. So I did a lot of standing or sitting right in front of him, which blocks him from standing. He ate for the first time since Saturday evening. Then he stood nearly unassisted and used the bathroom. Victory. And washed and dried his own hands (I pushed the soap dispenser handle for him). Walked back to the chair. I dumped the tiles on the table and we flipped them. He got tire of that, so I put the laptop on the table and started a Tyler Childers playlist. Casey sang Whitehouse Road, then fell asleep. I left the music on soft. He woke up after awhile and needed to go to the bathroom again. I hit the call button for the nurse, and stood in front of him to prevent him from standing. He slid his foot up between my legs. Good Lord, same old Casey. I sat on the arm of the chair with my legs blocking his escape and we chatted a bit. God, thank you for giving me fresh glimpses of my husband. He said why can’t we just get up and go. I explained again that he has a drain in his skull (we’ve nicknamed it the brain drain) and we can’t stand him up without clamping the drain off or he will lose too much fluid at once and end up with a bad headache. “Oooook,” he said. We made a bathroom trip and sat back down and reclined for a nap. I kept his fave tunes going. All in all, he was up on his feet five times throughout the day. He read some my blog writing on the laptop. He flipped through Family Handyman magazine.
All day long, he left his lines and IVs alone. I did catch him licking the EVD line once, and had to watch him closely on that, but overall he wasn’t fidgety until bedtime. At shift change, the day and night nurse asked the questions, and he went 4 for 4! For the first time! We moved him from the chair to the bed after one last bathroom trip. I put the laptop by the bed and started Gray’s Anatomy, one of his fave shows. I was exhausted, yawning at the bedside, distracting him when I would catch him messing with the adhesive covering on his IV, or trying to scratch his head around the EVD line. He was rocking his legs back and forth restlessly. Unfortunately, they cut him off the adavan, which is what calmed him the last few evenings to sleep. Dangit. I stayed at his side until he’d had all of his 10:00 meds, then the nurse restrained him and he was asleep shortly. I had the first good sleep since we got here.
TUESDAY AM. Feb 23
Neuro report was good this morning. He went 3/4 on the questions. Last night he went 4/4 for the first time and I practically acted like a cheerleader.
The day nurse and I got Casey on his feet this morning and he turned to me and put his arms around me and pulled me tight. Best hug ever.
Took a bathroom trip and washed his hands. Into the chair next, ate breakfast of eggs and potatoes. I started Gray’s Anatomy for him on the laptop.
Oiled his neck and shoulders. Oiled his feet and helped him stretch his legs and hips. Used Lemon oil on his left arm to remove the adhesive. Re-applied Yarrow/Pom oil to the inside of the entire left forearm, which was purple and black from wrist to elbow last night. It’s amazing how much better the bruising looks today. I brought YP for myself, and I’m glad bc it is helping with that bruising on his arms and hands, as well as helping my emotions.
I’ve been using the oils on him regularly, as the doctors don’t object. Magnolia on his earlobes, thumbs and big toes helps to calm him when he gets really fidgety and wants to pick at everything. I used it on his forehead a lot the first couple days to help the headaches. Frankincense and copaiba on every site before other oils, but especially on big toes and thumbs, which are the brain points. AromaTouch on the feet and the hips for neuropathy and pain in general. Balance on the feet and base of neck at least once a day.
A new person came in to see us. He’s a neuro specialist in the ICU. He told me we are probably in for a few bad days ahead bc of the vasospasms, that it’s going to get worse before it gets better, that even though he looks really good today, he probably won’t tomorrow. I am ready.
WEDNESDAY PM. Feb 24
No lengthy update today for a few reasons.
One, I’ve been keeping Casey occupied by watching Gray’s Anatomy on my laptop, which means I can’t type my updates on it.
Two, I can’t look away from him for too long or he gets himself in trouble. He picks at the EVD dressing or chews off his pulse ox monitor or peels off his IV dressings. I’ve been right beside him working on a beading project all day (easy to do while watching him closely) so I haven’t done any typing in my phone.
It has been a difficult last 24 hrs. That doctor yesterday was right. He took a disliking to his night nurse (Tyler Tidball lookalike, which is weird bc he likes Tyler) last night and was uncooperative and would not sleep, so delirium set in. He had hallucinations. This is obviously a hospital ICU room, but he sure thought we were in Leonard Forst’s machine shop. The brain fascinates but also scares bc sometimes I wonder if he will come back to me. We’ve been through hell last night and this morning, but I got him back after noon today and have had a pretty good afternoon and evening. This is when it gets difficult tho each evening. He gets fidgety and has to be restrained to keep him safe. Tomoro I will go looking for something for him to mess with at bedtime and other times when he needs a fidget toy.
He’s doing great right now, sitting watching Grays Anatomy, not trying to pick at his EVD dressing or pull out his IVs. However, he’s trying to peel the stickers off the bed rails.🤦♀️👹
They raised the brain drain apparatus today and will continue to raise it the next couple days and hopefully remove the EVD tube by Saturday. This is good news. We will still be in the neuro ICU until next week.
Please continue your prayers for no vasospasms, for steady improvement and complete healing, and add on peaceful rest for both of us. I don’t think I had this many moments of raw fear when both the girls were babies combined. Please pray I don’t have a heart attack lol. I keep my voice very soft, and I am pretty good at redirecting him when he gets frustrated. I redirected this afternoon by talking about moving the cows onto fresh grass.🤷♀️🤓
Much obliged and lots of love ❤️
Casey answered ALL THE QUESTIONS correctly for the neuro team this morning! First time for that!
Slept pretty good last night and is giving the nurses hell this morning as they give him a bath and replace his cardiac monitor stickies.
I asked for an activity apron on our third day. I was denied. One of the nurses this morning caught him chewing on his IV line and was all over him. I told her I need to find him something to chew on as he won’t chew gum, and he keeps chewing off his pulse ox line and chewing on it. I told her about the stickers on the bed last night and she asked if we want an activity apron. We should be getting one soon.
I called Leonard Forst and asked him to make Casey an activity board with tools and things to work the dexterity in his hands. I can’t wait to see what he comes up with.
The docs clamped off the EVD line this morning and are going to do a scan tomorrow morning and the plan is to remove the brain drain tomorrow!
Casey is more himself, but of course still very confused sometimes. Sometimes he is cooperative, sometimes he’s not. We are in this holding pattern of good day, then not-so-good day, then back to good, and so on. Yesterday was a not-so-good day. He seemed like he just wanted to rest and let his brain heal, which is great, but he was also combative and uncooperative and hardly walked at all. If you’ve ever heard Casey say “You’re not LISTENING to me!” then you know what I’m talking about. Today he’s walking with PT right now and I’m whispering quick prayers for a good day, falling in line with our pattern.
I am able to stay out of the way most of the time when he’s combative, as I feel I should be here chiefly for him to fall back on for support and advocacy. If I hadn’t pushed yesterday, I don’t think he would’ve gotten out of bed at all, not because he didn’t want to but because staff seemed to be busy elsewhere. Finally at 11 am he started fidgeting and pulling at his lines and I went looking for someone. I said “We have GOT to get him up out of bed or we’re going to have to restrain him during the daytime today.” I can’t help but think our day would have been entirely different if they had gotten him up before 10am amd walking.
Keep on sending those prayers and vibes. We need to pray for Casey to cooperate with PT. For his healing to progress steadily and completely. For him to eat well. For his right hip to become more flexible and ease the pain he is feeling there. For him to WANT to walk.
If things go according to plan, he will be released to a rehab facility next week.🕺🏻
This morning, after his walk, Casey passed on going back to the bed and sat in the chair. I offered to start Rust Valley Restorers, one of his fave shows, on the laptop, as it’s easier to watch the laptop while he’s in the chair bc the tv is on the wall by the door and he can’t even see it from the chair as it’s pretty much directly behind him, but he gave me a “back off” look and held the tv remote up defiantly and turned on the power to the tv on the wall, and turned the volume up to max. What a turd. He’s baaaaaack.
I got my jacket on and left for a little while. I went down to the cafeteria and got a Voodoo coffee (bliss!), a salad for brunch and a snack for later.
I’m proud of myself for not having turned to sweet or savory food for comfort at this time; sticking to a cleaner diet with healthier choices makes my body feel better and I feel good about myself. I returned to the room and sat away from Casey to eat my salad. While I was eating, I watched him try to catch hold of the balloon string from a helium balloon that Redneck, his employer, sent with an edible arrangement last week. He finally got ahold of it and began chewing on the balloon. I knew what he was doing: trying to be funny to ease the tension between us. I figured he had forgotten about the tv thing already, but apparently not. Crackle crackle crackle, the balloon said as he chewed on it. I said “that’s great casey, inhale helium, THAT’ll help your brain injury” just as he got the stem of the balloon torn open, took a deep inhale and cackled at me like a chipmunk.
He got up to use the bathroom around 10:30 and afterward he chose to return to the chair. I started Rust Valley Restorers without asking first. He has been in a pretty good mood ever since, watching happily.
He wanted to walk again around 11:30, so we got up and he walked down the hall a little ways.
It’s so hard to see him walk several hundred feet around the ward two or three days ago with only a gait belt for assistance, but today he can hardly go 20 yds and has to have a walker to assist. But the silver lining is that he WANTS to walk. I asked all of y’all in my tribe to pray for this just this morning. God shows me he’s here daily, I tell ya.
He stood this afternoon for awhile! Didn’t want to walk, but got up from the chair and moved forward to the edge of my bed (a sortof foldout couch), using the walker for support, and stood and looked out the window for 20 minutes or better before he tired out and we got him back into the chair. There’s lots to see out that window, and I’m happy he has taken an interest. He dug through all of my stuff that he could reach as well, and admired the bead project I began today.
The nurse was on his right and I was on his left. She asked us about the best vacation we ever took together. Casey: “We’ve never actually taken what you’d call a vacation.”
“How long have you been together?”
He faltered, unable to recall. This (5 days post-op) was the most lucid we had seen him since the brain surgery, and I could see she was trying to exercise his brain a bit, but it appeared he was done answering questions for a minute, and I continued for him.
“7 years…He’s right, and it’s hard with the farm and my business, but we do try to get away and go camping with friends from time to time.”
Last time we set up camp, we both left at some point during that 4-day getaway to go to work. Casey works most Saturday mornings loading trucks/trailers with deer blinds to go back out on Monday mornings, and I couldn’t pass up opening my studio at least once bc it was a holiday weekend. We camped out of my old jalopy 32-foot gooseneck horse trailer from 1982, which had been my go-to junk show trailer for a few years. It had simple living quarters with an air conditioner and a queen mattress space. Nothing fancy, but it kept us dry in a huge rainstorm our first night at camp. Casey tried to leave to go to work at 6am but flash flooding brought him right back to me. In the rear cargo space, I had packed stuff for the Trick My Trailer Contest. I set up our campsite to look like the set from Lonesome Dove. We worked together to make different areas set up like different scenes from the movie. We sure didn’t have a nice camper with comforts of home, but we had a comfy picket fenced “front yard” like Clara Allen’s with a fire pit surrounded by chairs, and we had a “front porch” with chairs and a spool table for playing cards that was right reminiscent of that front porch at Lonesome Dove where Gus was fond of drinking whiskey and reading The Good Book.
We ended up taking the trophy in the contest! It may be some time before we ever take what some would call a real vacation, or have a real camper, but we can make anyplace feel like home, and we truly enjoy each other’s company no matter the circumstances.
He likes our nurse today…yesterday, not so much. We had Jared, a male nurse, for the three days before yesterday. Casey liked Jared and did what he requested. Yesterday was a 12-hr battle with our nurse Vera. He got onto her for not listening to him several times. Last night we had Aneth, whom he liked (we have had her for a couple other night shifts), and today it’s Molly, and he likes her.
I’ve been eating here at the hospital every day, but tonight I’m using one of my Doordash gifts that have been given to me by wonderful friends. Casey is resting well after that long period on his feet, and I’m into the new beading project.
Keep up those prayers. The prayer for Casey to WANT to stand and rehab is working!!!
Pic of beading project bc I wasn’t able to sneak any of Casey today. He looks good though!
SATURDAY AM Feb 27
THE BRAIN DRAIN IS OUT!
One of the neuro team came in and removed the EVD (if you haven’t been following along, it’s an External Ventricular Drain that has been draining blood from the ruptured aneurysm out of the subarachnoid area of the brain) line from Casey’s head just a little while ago. He has two suture spots on top of his head. The line that came out was over 6” long.😳
I’m not sure when, but I think as soon as they know for sure his body is properly regulating his intracranial pressure (ICP), they’ll move us out of the neuro ICU to the stepdown unit on the 7th floor.
As the doc was numbing the area around the drain before removing it, I was standing watch (Casey doesn’t handle needles very well) and noticed spots where his blood pressure cuff had been. I pulled his gown to the side and it was everywhere. They had to give him a muscle relaxer last night to lessen his lower back pain (from being limited in mobility for over a week), and this morning he has a rash allllll over his body. They gave him benadryl for the rash and he’s snoozing peacefully.
Keep up those prayers for steady and complete healing. Pray for him to continue to WANT to walk and move, and for complete rest when it is time for it. It is apparent to me that this could have been SO much worse and that there is a reason Casey is with us. We aren’t totally home free yet, so he still needs y’all’s energy for a few more days.
Much obliged and lots of love ❤️
It’s a good day. Casey’s hip pain is VERY diminished, and he walked the longest loop of our corridor this morning.
There was talk yesterday of sending us up to the 7th floor, the stepdown unit, so last night I got our stuff together and organized and packed.
Alas, this morning, the neuro doc said we would be here in the ICU for another day or two. The sensitive window for vasospasms is not over yet, and we are here till it’s past.
The window is 14 days after the initial bleed. I’m not sure what kind of math we’re using here, but according to my calculations, we’re on day 15.
Whatevs. As long as he’s not climbing the walls or cussing the nurses, I’m happy to oblige. He called two of them “ya damn sodbusters” the other night in a delirious nod to Lonesome Dove.
He’ll be more comfortable in a regular room, so I’m looking forward to the 7th floor. Plus, it’s a step closer to home. Our nurse today said she is surprised they didn’t move him up today, bc it usually happens the day after the EVD is removed.
Anyway, Casey’s going to be a handful very very soon. Kinda like the 64-year-old lady next door…we hear her “tattle tale alarm” go off constantly! Her daughters said she’s a holy terror and they think they get to take her home tomorrow. I have listened to her play the lap organ and sing hymns several times since we have been here. Casey’s tattle alarm was going off every 5 mins this morning, so I’d say we are close to bustin’ out!
Picking the black olives off his chicken enchiladas with a fork. His fine motor skills are pretty impressive.So thankful.
Has taken us into a time where it is so much easier to be kind to others. I imagine a year ago, before mask mandates, here in this hospital I would pass people in the corridors without so much as a glance. Now we make eye contact and nod, we put forth the effort to emulate a smile when half our face is covered. We remember faces more than ever because we only have eyes and a feeling to portray ourselves to others.
Today was a not-so-great day. I wouldn’t say it was BAD, but Casey was back to wanting to sleep the day away. PT got him up and walked the big loop with him, and they said he did great, no walker to assist, just the gait belt and two PTs for backup. They “did the stairs” for the first time too! It’s a small set of three steps up, then a landing, then three steps down. He did them twice. Apparently that did him in pretty good.
I wasn’t around when they did this because my computer has been acting funny, so I took it to the Apple store and walked around the Plaza for a bit, exploring the Barnes & Noble for most of the time. I hung out in the sun on top of the parking garage for a bit when I returned to the hospital.
When I got back from the Apple store, he was snoozing soundly. Ramona, today’s nurse, said he has been sleeping since PT left and hadn’t eaten but a little bite of chocolate pudding for breakfast and no lunch. She also said he had been downgraded from ICU status to Med status, which means we are headed to the stepdown unit as soon as they have a bed for him!
OT showed up shortly after and wanted him to wake up and walk again. They were having no luck rousting him from his nest, so after listening to them sweet talk him for a good ten minutes, I got involved and got him to open his eyes first, then got him sitting up, then swinging his legs off the bed, then stretching, then standing. Then I was able to cajole him into walking out his door and touching the wall on the opposite side of the hallway, then back in the room to the chair. His hip was hurting him pretty bad despite tylenol and a lidocaine patch.
He was awake for a little while and went back to sleep. I ordered him dinner, and when it arrived, I prepared it and woke him up and pestered him into eating.
He ate a good bit, then nodded off in the chair. I reclined him and when I left to come down to the lobby, he was snoozing again, mouth open.
Hopefully we get to go to the 7th floor tomorrow morning. We need a change of scenery. He wasn’t sullen today, which was great. I have missed my random hugs and kisses that I get from him. Every chance he got today, he held me close. I’m like “oh hey, there you are!” I cannot wait to get him out of the hospital into the fresh air and sunshine.
To be honest, I figured Casey would be so sick of me after an extended hospital stay.
Exactly the opposite.
He would have refused to do PT yesterday afternoon and this morning if I hadn’t been here.
He would have refused meds the last two times as well.
I am so grateful my husband loves me so. His behavior is off because of the buildup of fluid in his brain right now. He hasn’t been too nice so I’m grateful he allowed me to caress him into complying. I never would have thought it possible.
Casey walked quite a ways this morning, but I had to beg him to open his eyes, get out of bed and do something. He walked forward, backward, sidestepped, then walked forward some more. He finally let me cut his hair, scrub his scalp, give him a bath, then I got him to brush his teeth. It had been several days, and they’ve been only allowing him milk to take his meds because he’s been on a free water restriction for low sodium levels. So….Yucky mouth. Like there is white carpet on his tongue.
He has been really lethargic and just not acting on par with what I was seeing a few days ago. I said something about it yesterday, about him being sleepy and not really too peppy.
He had a brain scan done three nights ago and they took him again early this morning for another scan.
I’ve been expecting Dr. Camarata, the head neuro guy on Casey’s case, to come in all day. He just left a few mins ago. He said the scans showed that the ventricles in the brain are getting larger, which means that his body isn’t regulating his intracranial pressure.
The extra pressure is the cause of his lethargy and his diminished function. We should be seeing him improving steadily in an uphill type of fashion, but we are seeing peaks and valleys.
They’ll place a shunt sometime in the next day or two, he will start improving rapidly and we will be out of here by the end of the week. The shunt will drain the excess fluid into his abdomen.
I’m working on inpatient rehab options for when we leave. Looks like a two week stay at Springfield or Joplin, but I haven’t made the final call just yet.
We just got moved! We are on the 7th floor now, with a view of the sunset. The room is private, exactly like our room on 5 but with a lot less equipment.He goes into surgery for the shunt install at 7:30 am tomorrow.Please pray for Casey’s surgery teams (neuro is placing the shunt and general is placing the drain tube in his abdomen), for an uncomplicated procedure, for a realatively painless recovery from the surgery, swift forward momentum with rehab after the shunt is in place, and for steady and complete healing, my friends.
WEDNESDAY AM SHUNT SURGERY
Dr. Camarata just came to see me. He said he left the surgery while general was placing the drain tube and Casey was doing great. He’ll go to recovery and then be back in the room with me. We should see marked improvement by tomorrow! AND there is a good possibility we’ll be out of here Friday. I’ve been making bracelets to pass the time and they are beautiful…I auctioned one on my facebook page and had great feedback.
Soaked up some sun outside until the building’s shadow caught up to me and it got chilly.
I got the call just a little while ago that Casey has been accepted into Mercy Rehab Springfield. Hopefully we’ll catch a transport out of here tomorrow.This facility has a board-certified specialist in Neuro Rehab.
We are bustin’ out!!!
I beat the transport to Springfield, so I’m sitting in Casey’s room awaiting his arrival. The transport took him to the wrong hospital! He has a private room here with a decent view, on the ground level. There’s a courtyard where we can bring Nev and the girls to visit. He was so tired when he arrived at the rehab hospital because he had been sitting upright in a wheelchair for nearly 4 hours by the time they got him here!
Things about KU
Things I haven’t talked about in my journaling but want Casey to know later…
Approximately 2000 mL of CSF and blood is what was removed from his brain through the EVD overall.
When they removed the EVD line from his brain, CSF spurted out the hole with every heartbeat until the doctor got the hole sutured shut. I’d say I beat Casey…he got to see me practically cut in half when I had a Cesarean when delivering Cale, but I watched a doctor pull an 8” tube out of his brain.
His sodium levels tanked in the second week, so they put him on a free water restriction. He was only able to have chocolate milk to take his meds. He didn’t want to swallow them whole, so he chewed them up. Chewed. Up. Salt pills. And alllll the other pills. The nurses would practically beg him to just swallow them, as some were time release and chewing them up ruined the efficacy during the later hours after the meds were taken. He chewed them anyway and spit the shells on the floor.
He went through at least two dozen pulse ox monitors. He would chew them off his finger, then chew on the line until it was mangled plastic and bare wire. He finally quit doing that after the first week, when the tobacco withdrawals stopped.
He liked most of the nurses. Nothing against those nurses that he didn’t prefer; they did a wonderful job despite Casey being a total pain in the ass. Aneth (pronounced Annette) and Jared were his favorites.
He isn’t super fond of Dr. Camarata, the head surgeon (maybe not over the whole neuroscience department, but he is the head honcho over Casey’s brain). Casey said on day 4 that he’s too cocky, and I can tell Casey doesn’t like talking to him. He really tries to answer Camarata’s questions solely with sarcasm. I suspect it’s because Casey has this innate dislike for having his picture taken, and Dr. Camarata is always taking video when he’s in here. He posted the videos to a family progress app that our closest friends and family followed throughout the stay. I think he’s a nice man.
On day 6, the fire alarm began going off in the evening. A loud intermittent buzzing, alternating with a super loud recorded announcement that repeated “A FIRE EMERGENCY HAS BEEN REPORTED IN THE BUILDING. EXIT THE BUILDING IN AN ORDERLY FASHION USING THE STAIRS. DO NOT USE THE ELEVATORS.” It droned on and on. Our nurse, Rachael, popped her head in and said she didn’t know if it was a drill or not, but she would let me know. Standard fire drills had been run just the day before throughout the building. She slid our door shut, then shut the two doors outside our room that divide our corridor in two. The alarm went off for a good ten minutes when it was interrupted by an announcement. A woman’s voice said “CODE RED SECOND FLOOR CODE RED SECOND FLOOR”, then it returned to “A FIRE EMERGENCY HAS BEEN REPORTED IN THE BUILDING” Eventually, the alarm stopped, and reports of what happened trickled up to us on the 5th floor. A woman entered the tower, screaming about having chest pains, stripped off ALL her clothes, evaded security and made it to the second floor, where she reportedly pulled a fire alarm in her distress. Casey slept through the whole thing. I had my backpack loaded with computer, phones and wallet and was ready to follow his bed out the door if we had to leave.
When I was up there, my body had a different smell. LIke it’s microbiome had been disturbed and it was letting me know something was up. I don’t know if it was the super duper clean environment that my microbes didn’t like, or just my brain telling my body we were in a stressful situation and to do what it needed to in order to get by, and my body got rid of the stress in the form of BO.
Smells pull some powerful memories from me already. They flash me back to the Neuro ICU where we spent 14 days.
I was so calm there. I dealt with everything with a serenity that is not characteristic of me. I’m an emotional person and I wear it on my sleeve. I’m opinionated in general and protective of my tribe. But I was quiet and observant there, and I formed my opinions slowly and carefully. My protectiveness muted itself to a level of dedicated advocacy. I know him best. I know what his habits are. I can serve him by being calm and using my knowledge.
I was calm when it mattered, for certain, but I cried plenty too. I cried because of the kindness I was witnessing. Because people were praying for me and I could feel their thoughts wrapped around me. I cried because I felt a measurable amount of guilt for not dragging him to a hospital kicking and screaming two days earlier. I cried because I was afraid Casey would be changed forever and wouldn’t like me anymore. I’ve heard stories of couples who divorced after a stroke or other significant health event and I was so afraid I would end up being a single mother again after enduring this nightmare.
I thought I cried a lot. But that was nothing. Pretty much after we crossed the Barton County line and passed Lamar on our way to Springfield, I was a teary mess. I rolled down my window and smelled the air as we passed the exit we would normally take to go home. I was less than 4 miles from the homestead.
After I checked Casey into the rehab hospital, I went home for the first time in 17 days. I have never been gone for that long. People don’t even vacation for that long. Or if they do, dang…I’ll know I have arrived when I can be gone for that long and be okay with it. When I pulled in at the house, Creek met me first. She cried and cried. Nev was on her heels, and she sat at my feet and howled while Creek cried. After I had Creek calmed down, Cale came hoppy-skipping outside and said “MOMMMMM!!!! I’ve missed you!”
I wanted to just eat dinner and go to bed with both of them. My own mom had set me up just so we could do that. She made sure we were all happy and sacked out. I had brought them some gifts to ask forgiveness for leaving them for over two weeks, and they opened them and we played a bit.
We fell asleep watching Cloudy With a Chance of Meatballs. I woke up at 1 am, about to fall out of the bed. I had to make Creek go to her own bed. Sad day, I know, my bed isn’t big enough for the three of us anymore.
I had intended to get going much earlier on Saturday so that I could be with Casey soon after he woke up, but that didn’t happen. Instead I had a nice leisurely morning where I didn’t have to talk to any doctors, just the cacophony of my kids, over breakfast. We walked around and checked all the animals together before I got ready to go.
I drove to Springfield and spent an hour and a half with Casey. He was about to get in the shower when I arrived. His first shower in over two weeks. He was able to stand up and shower, which was a huge relief for me. I had stopped last night and gotten him some elastic-waisted pants and shorts. I had laundered them at home and gathered a few other things, including his favorite t shirts and his Keen tennis shoes. I set him out some clean clothes. The nurse that was there when I arrived said I could assist with his shower, and she left. When he got done, I helped him dry off and was helping him dress when he cracked a joke. I started crying. He wrapped his arms around me and let me cry and cry. I told him this is what happy looks like for me right now.
This was the first time to see him in actual clothing in like forever! No more hospital gown!
The doctor came in while I was there and told me he has to have a tent installed on his bed because he won’t call for assistance before getting out of the bed. They’ll install it sometime today. He won’t be able to get out of it without help.
He was pretty worn out after that shower and dres
sing, so I left him to nap and went and met my old friend Jenifer and we hit the flea markets in Billings. It was so nice to be out and about, in my element really, among the musty antique shops.
I returned to Casey around 4:00 and stayed with him until he was ready for bed around 7:30. My plan was to wean myself off of him until I could handle being away for a whole day. I drove home that night and stayed, then returned Sunday.
I brought the girls and my mom on Sunday. We went to my friend Casey Jo’s house first.
I left the girls there and had Mom deliver me to the rehab hospital. I wanted to see how Casey was doing today before bringing the girls to see him. Due to Covid rules, they weren’t allowed in the hospital anyway, and we would have to facilitate conversation through the cafeteria windows. He was doing good. I sat with him while he ate lunch, and the therapist that accompanied us asked me some questions about how our home life would be after we got out, how I planned to take care of Casey, and if I would be ok with prompting him to do the things he needed to do in order to get back to a routine. After lunch, he wanted a nap, so I hung out and worked on the bracelet I had started the day before we left KU Med.
Mom had some errands to run for me and for herself, so she gave me a heads up when she picked the girls back up and headed to he hospital with them. I was able to get Casey woke up and interested in seeing them. It was more of a chore to him because he was just tired. Here at the rehab hospital, they didn’t wake him and poke him like they had at Ku Med, so he was loving the quiet and rest. He let me push him in the wheelchair up to the cafeteria. We put mom’s phone on speaker and my phone on speaker, and the girls said hi to dad. He showed them his scars on his head and his belly.
I don’t have any pictures of their visit because my phone was on speaker.
Maybe 10 minutes of watching them throught the windows and talking on speakerphone and he was worn out, so I took him back to his room and tucked him in before leaving with mom and the girls.
I have less than three days to complete a mountain of tasks assigned to me by Casey’s doctor, Dr. Bell. Caring for a TBI patient can be akin to caring for a toddler, so there are protocols to follow.
Get the guns out of the house. I catalogued the guns and move them to a safe at our friends’ house.
Get all the knives out…so, all of our hunting knives, filet knives and all of my sharp kitchen instruments.
Get all of the power tools locked up…I’m not sure if I laughed or nearly vomited when she said this one…I didn’t bother to explain my reaction, there was no way she would understand….so, I have a workshop connected to the house, complete with chop saw, table saw, at least a dozen electric and cordless power tools, hammers, pry bars, screwdrivers, an entire wall of these things and scissors and box knives. I Have a metal shop for building my art just off the side of the house that is full of my metal art junk, including saws, sharp rusty old farm tools, hammers, pry bars. Casey has his own shop there at the homestead too, a completely stocked auto shop.
Take all the keys and hide them. We had 4 pickups and 3 tractors on the place at the time.
Get rid of all evidence of liquor and tobacco. Four different pickups with beer cans and chew cans hiding in little crevices. His daily jacket and all his winter gear to scour for spare cans of chew.
Clean and de-clutter the house.
We had been shut up together for nearly two weeks of frigid cold when we were swept away by the aneurysm and gone for 17 days and only had 2 whole days in the last week to attend to the homestead, the kids, the house, the wood pile. Mom and my bestie Steph had rearranged the house a bit and moved my sewing stuff so that we could get an easy chair for Casey.
Clean up the winter limb fallout under the pine line, a row of giant pines in our back yard. Lots of limbs down, and we had plans to limb up all of our pecan trees when we got a chance to clean up the limb mess. I had Brad Forst meet me and we tackled it together so that Casey wouldn’t feel like he needed to get out a chainsaw and get to work.
I also hadn’t seen my cattle in over three weeks, and I took the time to go check them two times, see how far off my calvers are at this point, assess how long the grass is going to last in this rainy weather and how soon we will need to move them out of there lest they stomp the grass lots into mudholes.
Wednesday March 10
Casey has been at the rehab center for 5 days. Since Friday, he has improved immensely.
I atttended PT with him this morning. He climbed steps, got in and out of the car in the therapy room, walked outside around the building, then did some balance exercises to finish.
His therapist today said moving forward, balance would be the main focus of his PT.
She said this, I assume, because he is nearing completion of the mobility goals set forth by the facility.
She said there is talk of sending him home by the end of the week. That’s in 2 days.
This is a little scary because I don’t have everything done yet that I wanted to accomplish before he comes home.
WE ARE HOME!!! Sorry this is kindof sudden, but it all happened…suddenly. I was informed Wednesday that I could bring him home Friday, so the last two days have been a whirlwind of activity. I had a mountain of tasks to achieve (stuff I totally hadn’t thought of) before bringing him home. I was given a list of things to accomplish by Casey’s doctor, and I was handed a “brain injury playbook.” On Wednesday. With orders to take him home Friday. THIS has been the most stressful time so far as caregiver…the last 7 days, since we left KU Med. I visited Casey a lot, but I had case workers calling from the rehab hospital while I was trying to accomplish things on the days away from him at home, and I felt very torn. I had been given a list of things to accomplish, but they were wanting to know why I wasn’t there. They made it seem like Casey really needed me there in Springfield, and while I knew I was serving him better here at home, it was simultaneously funny/a relief/very hard on me to hear that he behaved so much better when I was around. He said “inappropriate things” when I wasn’t present, but they noticed when I was there, he acted completely different. I was informed that I am experiencing PTSD, so I’ve been dealing with my own wacked out emotions throughout this period. I thought I was ready to see people, then decided after a town trip on Tuesday, I should prolly not do that again until I can talk to someone without crying tears of joy and relief. I would have drowned in tears and work if not for the help of friends, family and neighbors. It’s so good to have him home.
My husband’s revenge: doing all the things that usually drive HIM crazy, with zero repurcussions.This is meant to be funny, so just take it easy there. I’m extremely grateful I still have him around to clean up after. Miracle whip and mustard on the kitchen counter, beard hairs all over the bathroom sink, the air hose strung across the ground…. I’ll pick it all up, all day, every day.
We are doing a few normal things like riding 4-wheelers and exploring the woods again. No driving large vehicles though.
Look who got new glasses! He thinks he should be able to drive now.He has an appointment with a retinal specialist Friday to see what they’re going to do about the blood in his right eyeball. He has very little vision in the right eye and the left has several little hematoma (that’s plural for “hematoma”…i just learned that from autocorrect) that are causing interruptions in his peripheral vision.The outpatient rehab is going really well. They’re working on his immediate memory. He advances more each day; it’s pretty amazing. We are getting a routine going. The hardest thing is for him to put his feet on the floor and get moving, but he is getting better at it every day too.We still need those prayers, my friends. They’re prolly going to want to do a procedure where they draw all that blood and fluid out of his eye and replace it, then see if that improves his vision on the right and see if they can get a good clear picture of that eye, which has been inpossible bc he can’t focus for the machine to take the pic. But we will see what they say.We also go back to KU Med for the first time next week to see Dr. Camarata, the neurosurgeon who oversaw Casey’s case.
When people ask how Casey is doing, I say “He’s still funny, thank God.” Tonight while eating out, I got the first text message from him since February 15, while sitting right across the table from one another. He was calling my attention to another patron who had eyebrows like Charles Manson. It was hilarious. I cried sitting there in the restaurant simply because I was overjoyed that he typed a message and hit the ‘send’ button.
I texted him regularly while he was at rehab and afterward when I wanted to tell him something, but he never answered. It was a symptom of the frontal lobe damage from the bleed. The frontal lobe is responsible for short-term memory, task initiation and personality/sense of humor. If anyone called or texted, he could read it, but he couldn’t answer.
I told him now that he had sent me a text, he needed to start answering his buddies. Jeremy and Tommy texted him regularly, but he hadn’t answered them yet.
This is a huge sign of progress in my eyes. A step back to normal. Every day is progress, new things, and I’m reminded of when I catalogued every new thing my babies did when they were very little.
March-June…Casey’s brain healed and we all just existed together for 3 months. It was like being in 2020 again. In the COVID shutdown, Casey was off work for 6 weeks. This was much longer, but similar. I look back and think those two years were a gift to us. They made us realize life is short, and we have been given the opportunity to slow down and enjoy it. I have ever since been trending toward honing my purpose down and doing less, spending more intentional time with family and friends, and stressing less over growing my business.
April 7. We went back to KU Med and Dr. Camarata checked out Casey’s progress. He just wanted to lay eyes on him and talk and check his vitals. Everything looked great. We go back in July so they can check the coil surgery to see how it’s holding.
April 10. Friends Helping Friends, a charitable organization of which I’ve been a member for 10 years and helped with numerous charity benefit events, held a benefit to help Casey and I with our bills.
I’m super fortunate to have people like these in my life. They’ve been planning this event since we were at KU Med, so we are happy to see our people and celebrate Casey’s recovery. My bestie Stephanie was in charge of the event and did an amazing job. It was a chilly evening, but we had over 200 people attend. My bestie Liz came in from St. Louis to be here with us.
The benefit releived a lot of pressure on me. KU Med was breathing down my neck. We had a giant ambulance bill from when they transported Casey to Kansas City from Lamar. I had my business bills to pay, utilities for the homestead and for the studio, and our tax return ended up being held by the government until late July, so we needed help, and this event made the next two months of Casey’s recovery so much less stressful for me.
CASEY IS RELEASED TO DRIVE!!! MAY 13
May 14, we traveled to Iowa to see my nephew Wyatt graduate from high school. We stopped at the West Bottoms on the way through Kansas City, and I had Vickie snap a shot of us together.
June First Friday in KC West Bottoms
Casey went back to work the last week in May, and I went back to my studio. Carla came in the first week after I was opened back up, and she offered her help. She’s my ride-or-die studio manager, and I couldn’t live without her. My business began to make a transition at that point, and it’s still transitioning, but having Carla at the studio allowed me to turn my focus to my metal art.
My cutting began to evolve at that time because I was able to be home and had the freedom to spend more time in the junk shed. A lot happened in June in regards to my plasma cutting.
I had planned to be in Branson in the fall for Silver Dollar City’s Harvest Festival, but I shelved the application after Casey’s aneurysm. The thought of doing other fall events wasn’t off the table, but I hadn’t scheduled anything yet.
We always make time for the homesteading activities, and its easy to keep up since we are able to be home because I have help at my studio space. We live a homeschooling lifestyle, which means we are always learning and teaching one another.
We also learned in June that Mom had breast cancer again after 8 years in remission. She was scheduled for a bilateral mastectomy July 2. I went with her to appointments with the surgeons and the oncologist, and I took her to her surgery.
At that time, I had been making the more detailed luminaries for a few weeks, and they had been a huge hit.
I still had no hopes of SDC, and I was thinking that fall events were a no-go because Mom was slated for 4 months of chemotherapy, twice a month, with checkups on off weeks. I figured with an appointment every week, I needed to be around.
July 13, Casey and I went to KU Med for a followup angiogram, or arteriogram. They entered a vein in his forearm and traveled all the way up into his brain to take images of the coil surgery and see if it was still holding.
We struggled to get Casey’s blood pressure medication straightened out in the beginning, but by August, he had it pretty much lined out, and he feels good.
I can say now, a year later, that he is back to 100%. He has his sense of humor, he gets up and on his feet at 5:15 am every day to go to work, he takes care of the wood stove every day and is back to cutting and splitting firewood and making plans. He told me a few days ago his plan to “do a month-long weekend cutting marathon, then do a split-and-haul marathon until we have the grain bin full, a stack outside, and all three pickup bed trailers full and parked in the barn.” I almost cried because this is enormous. It’s planning, task initiation, and all the things he lost for a year.
We are closer than ever. It used to be normal for him to be gone of an evening, out visiting with friends. I never worried; that has always been one of the best things about our relationship, that we trust one another implicitly and there is no jealousy or possessiveness. He doesn’t stay out anymore though. He hangs out with me in the shop. The girls are always with us and underfoot. We talk about our day, what’s coming up tomorrow, and what we’re planning for dinner. He helps me with my work when I ask.
After Casey’s appointment in July, I was published in ShowMe the Ozarks Magazine. It was my first published writing outside of my blog since I lived in Tennessee and wrote for the Memphis Commercial Appeal over 12 years ago. I wrote my own article about how COVID and Casey’s health crisis changed the course of my business. I also took my own photos and submitted them for publication.
I wrote about doing Live social media feed and how that helped drive sales on my website. I wrote about our entire experience, and I was beginning to feel that life is too short to even be doing all the things I wrote about, and I have since stopped doing some of those things. It’s interesting to see what I wrote about and reflect that we still continue to see how Casey’s aneurysm changed us forever and made us see what’s really important.
The Live videos of me plasma cutting were a hit. I was cutting product Live and people were on there watching and requesting customs, and I would cut them right there on camera. It was a lot of fun, but not as fun as in-person Live events. I still yearned for another experience like the Scenic Drive Festival in Iowa 2020, but I thought it just wasn’t in the cards for me in 2021.
When Silver Dollar City contacted me in August and invited me to the Harvest Festival, Casey and Mom were on board 100%. An employee of SDC (she related this story to me when I was there working…I thanked her for getting me there!) was watching me on a Live during the Lamar Fair, and she called up the Event Coordination staff and told them to get on facebook and watch me right now. They emailed me right away, inviting me to work down there during the festival.
It was hard for me to let go of taking Mom to her appointments, but i knew we had great support from her sisters and her coworkers to drive her around and to help with Cale, who is in preschool this year. She also had a fantastic patient advocate who went to many of her appointments, so I felt she was in good hands. Creek went with me to SDC and helped.
In the weeks approaching the festival, I took Mom to Joplin once a week for chemo and followups, and while she was at her appointments, I scurried around Joplin, shopping in thrift stores and antique warehouses looking for metal items to cut into luminaries and to take to SDC for my plasma cutting demonstrations.
As the weather cooled (in late October here in SWMO), Casey added the wood stove to his routine. I was afraid he wouldn’t be able to handle it all, but we had a talk about it in the beginning of October, and he immediately began making daily effort to work the task in and by the time we needed to be feeding the stove twice daily, he was on it.
He took care of everything for me when we were gone throughout the fall. I only had two weekends at home between Sept 15 and Nov 15. I would breeze in first of the week, make a dash to unload and regather materials for the next event, then take off again, sometimes for an entire week. It was a fantastic time for my business, but it would take its toll on me.
Mom finished her chemo regimen just before Thanksgiving. I had finished my fall tour a couple weeks previous, and I was in “rest” mode. We stayed home for Thanksgiving. We normally travel to Iowa to see my sister and her family, but Mom was really worn out and not on the upswing just yet from the chemo. She had lost sensation in her fingers and toes, rendering her unable to even do her embroidery work.
By the time Thanksgiving arrived, I was tired. I didn’t want to do extra, and I was sleeping a LOT.
I realize that I overloaded myself after a very stressful time without really allowing myself to recover from the emotional stress that I had been under for 6 straight months.
I had been the hub of our family. Nothing happened without me doing it or telling someone else to do it. Casey. Mom. The girls. Our homestead. My studio. The farm that Mom and I own together. The farm that Mom owns with her siblings. Our livestock. I was tired. I was going through the motions, but I was just worn out all the time.
I finally feel energized again. It’s like I hibernated through January.
I realize that life is too short to do ALL the things. So as I mentioned, I continue, a year later, to hone things down and take things off my plate. I’m focusing on my metal business and not putting energy into allllllll the other salvaged materials art. I’m focusing on being in my furniture workshop. I’m still marketing salvaged materials. I’m not doing events unless they’ll permit me to bring my trailer in and do Live Art for the masses. I’m not doing workshops at my studio, and I’m scheduling very few at my homestead workshop. I’m home evenings with my family. I’m working on knocking out all the custom orders that have been on my plate for months, then I’m going to be very selective about what customs I will do. I’m doing more of what makes me happy.
My truck, the ’03 Dodge Ram 2500 that I purchased when I was pregnant with Creek, is getting pretty old. We talked about it after the holidays, and Casey agreed that we need a better truck and a toy hauler with living quarters so that I can travel, work and sleep without unloading everything and renting a place to stay. So we bought a 2008 Ford F350 and a 2013 Forest River Work & Play, and we have been working on turning the garage area of the camper into a little workshop.
So now, after years of talking about having a “toter home” and traveling around the country junkin’ and makin’ art, we have taken the first step, and 2022 will be the year we shift fully into the business of our dreams. We have 3 events on the schedule that allow me to have my rig right there where I will be working, and when we go to Silver Dollar City in the fall, we’ll have our own little place to sleep, complete with a workshop in the back to work in the early mornings and evenings.
As the anniversary of the aneurysm approached, I began reliving it. There is some reason that God chose to put me through that, and I suspect it’s so that He could call my attention to the things that really are important and settle me into the niche for which I was truly created. I’m truly thankful for everything I have been given and everything we have earned, and I’m looking forward to honoring the gifts that God gave me to create and to delight others through art. I became close to Him when Casey was at KU Med, and as I have involved Him more and more in my business, the more I feel we are in the right place.