Monday

Dad: "The Santa Barbara Rehabilitation Clinic is just absolutely outstanding. Noah had physical, speech and occupational therapy today. Each of the therapists were well-trained, highly professional, and sensitive to Noah's needs. They were also very communicative with us. Noah will be doing outpatient therapy 3 days a week.

The speech therapist emphasized how important rest and avoidance of over-stimulation is for Noah's recovery. We are going to add psychological counseling and neuro-optometry to Noah's increasingly full plate (thanks cousin Kenny for running interference with the hospitals and the insurance company. You are just the best). Ultimately, Noah will be getting "homework" as he begins to overcome aphasia. We are betting that with Noah's fantastic support group, he will "break the record" for recovery time. How thankful we are to all of you.

Please remember to call Lailan before planning any visits....."

Friday

Dad: "On Saturday another wonderful chapter begins in the "Noah Miracle." We will be driving Noah back to Santa Barbara in the morning!! We have been advised by the doctors that we must avoid "over stimulation" at all costs and that he will be fatigued by the long drive. Accordingly, please understand that we will be enforcing "visiting times" for Noah and limiting the amount of visitors at any given time. Please call Lailan before visiting. Noah is still without a good part of his skull. It is our hope that Noah will begin outpatient therapy in Santa Barbara next week. His safety and therapy are key to his recovery. This will not be an easy or simple process.

Having said that, how very far we have come and how very thankful we are for the support and love you have all shown. Irrespective of which faith or beliefs we prescribe to, we've come together and created an incredible support team for "the boy who deserved a shot." For this, our family is eternally grateful."

Monday Morning

Today marks my return to the real world (the office)... so updates may become a bit more sporadic. That said, I will still be seeing Noah every day, and will do my best to keep everyone in the loop.

The biggest and best news as far as I'm concerned is that yesterday Noah moved his right toes. Since Noah's surgery, Noah had been unable to move his right toes and barely able to move his right foot. Yesterday, after nearly 3 weeks, Noah regained movement in his toes -- something that had all of us concerned. His movement remains very limited, and he is only barely able to move them, but it's coming back!

As some of you may have noticed in my August 8th post, I shaved my head after Noah's head was shaved for his brain surgery. Apparently, however, I'm not the only one....





Noah's therapy continues -- as does his progress. Noah beat us multiple times playing Gin Rummy yesterday, he's taken a couple walks in the park (see below), and he continues to make us laugh with his undiminished sense of humor.





Noah with his therapist Shelby

We continue to appreciate the relentless support, love, and prayers that you all have given us. I cannot stop reminding myself what I would have given to be at this point 2 weeks ago... in a post sometime soon I will explain how far we've come, the odds that Noah beat, the countless miracles that occurred to keep Noah alive, and yet, how far we've still got to go. Love to you all.

Saturday

Dad: "Noah had a full day yesterday. He walked upstairs by himself (holding the railing) and came back down. He went outside for the first time in 2 1/2 weeks (on the patio). Noah also started on some incredible software programs on the computer. Bless those nerdy programmers.

Progress continues. We are encouraged but will not be satisfied until Noah is 110 percent. Our hearts and love go out to the "tribe" of Noah faithful. So far we have over 2500 distinct hits on Noah's website. I think we should start selling advertising."

Thursday

Noah just before his discharge from Western Medical and transfer to St. Jude's



St. Jude's Medical Center in Fullerton


St. Jude's is a very nice, modern facility -- and the therapy Noah is receiving is phenomenal. Every day he undergoes about 3 hours of therapy -- including occupational therapy, neuropsychology, medical social work, speech therapy, and physical therapy. His progress continues to astound everyone around him, albeit he has some serious work to do.

Noah is still unable to move his right toes, and has some numbness and pain in his right foot. As a result, we took an xray of his right leg, which came back healthy. The doctor believes this could mean one of two things -- nerve damage or a herniated disc -- but more likely the former. One of the doctors theorized that he did damage to his leg when he fell as a result of his rupture (16 days ago), but because we were so concerned about keeping Noah alive, we didn't catch the leg problem.

Noah got his stitches removed, and an updated CT Scan, which was compared with a scan taken a couple days ago back at Western Medical Center. Albeit this morning had us very scared because his swelling and pain seemed up, the doctor gave us very positive news tonight. Noah's swelling is down, and he appears to remain free from hydrocephalus -- let's pull for that trend to continue!

Noah still is missing a piece of his skull about the size of your hand that will have to be put back in (see below). We had heard that this might not happen for many months, but because Noah's swelling is down significantly, we might be able to put it back in sooner than anticipated -- of course Dr. Tabrizi will make that decision.


This is before Noah's stitches were removed.

This afternoon, the speech therapist had Noah write the names of his mother, father, and brother. To be honest, he had a very tough time with Mom and Dad, but when it got to me, he put the pen to the paper and wrote B-A-L-L-S, looked up at me and laughed.

I'm starting to suspect that Noah is enjoying himself. He refused to eat the hospital food tonight and had me go pick up a bunch of sushi, guilt-tripped my mother into about 2 hours of back-scratching, watched about 3 hours of television, and forced me and others to massage his un-toe-nail-clipped feet...while leveraging his inability to move his toes. Suspect.

goooooo NOAH!

Tuesday

The following story might be inappropriate, but like Noah, I've lost my filter after this 14-day emotional rollercoaster... so beware...

Two days ago, Noah was having a hard time urinating, and they had to administer a catheter. I've never seen Noah scream as loud in his entire life... he was shrieking like you cannot imagine. When it was over, the nurse told Noah that she'd give him 2 hours to urinate on his own, and if he couldn't, she'd have to do it again. About an hour into it, Noah said, "I have to pee," and asked to go to the bathroom....but he couldn't go. In a panic, Noah looked at me with utter desperation and said "Dude, please, teach me how to pee." Long story short, we figured it out. In any case, ever since this experience, Noah has taken the opportunity to tell everyone he meets (including 60-something-year-old female nurses) that he can pee... obviously as a means of making sure that nobody comes near him with a catheter. Anyways...

This morning, Noah called me on my cell phone at 6:30am and said, "Balls, where are you?" (Balls is an endearing, I think, nickname that Noah called me BEFORE his rupture...amazing how the things you want him to forget...). I showed up just in time to go to Noah's 7:30am CT Scan. On the way to the scan, Noah made friends with the guy pushing the gurney. One of the first things he tells the guy is, "Hey... I can pee." It took a little explaining...

But, back to my comment about Noah not having a filter... This morning, Noah's in the CT scan, and I'm outside the room because I can't go near the xray. So I guess the xray was operated by a female attendant... and I hear Noah yell from inside the scan, "Hey Balls, this girl is sooooo hot." Followed by an explosion of laughter from all of the male employees in the room... I never got to see if she actually was :)

Tomorrow morning, Noah will be transferred to St. Jude's to begin serious Neuro Rehab. We are so blessed to be at this point. It is a miracle. What we would have given 14 days ago to be where we're at. Noah continues to make progress, and I'll close with a couple more photos that say it all:



Noah and Dr. Tabrizi





"The Three of the Boys"

Monday

This is how today started...

Dad: "Noah, what day is it today?"

Noah: "I can't remember."

Dad: "Can you say Monday?"

Noah: "Mon..."

Dad: "Mun-Daay"

Noah: "Mun-dee?"

Dad: "Noah, when you can say all seven days of the week, I'll buy you the new Blackberry."

Noah: (looking at me): "Let's do this!"

(30 seconds later)

Noah: "Monday, Tuesday, Wednesday, Thursday, Friday, Saturday, Sunday. Gimme my free ****!"

Noah's progress is staggering. He still has a long way to go, but it is truly remarkable and breathtaking to watch him re-boot from hour to hour. He has aphasia -- and is needing to re-learn everything from reading to large parts of vocabulary and named retrieval -- but he is improving noticeably every day. Most of his memory seems intact; but he has a very hard time expressing himself. As a result, he sometimes gets frustrated and, for now, we still need to limit the number and length of visits.

Although Noah can move his left toes with ease, he is having a very hard time moving his right toes -- that said, today he began physical therapy... and we are thrilled to share another photo that says it all:




Watching Noah taking his first steps again was unreal -- he was absolutely fearless.

It's looking like Noah could be transferred to St. Jude's Medical Center in Fullerton on Wednesday for rehabilitation services. This is obviously another enormous step forward.

Today, Vicky -- an ICU/ER nurse who was there when Noah first came in -- visited Noah and was in total disbelief. Like many other doctors and nurses, she believes Noah is a miracle. As my mother says, "there are no imperfect miracles" and we believe and pray that Noah will make a full recovery.

Words cannot describe our joy, gratitude, and love for all of you.

A Message from Noah

Noah Kawika Fell (while looking at the collages of photos made for him by his friends): "Wow, I have a lot of friends. Can you tell all of them I just want to say thank you so much and I love everybody."

End of Day Saturday

Despite the fact that my brother keeps calling me Louie (and sometimes thinks I work at the hospital), I'm getting the feeling he knows who I am. My father showed him a picture of me and him today, and asked him who I was... his response: "Some dork" -- as he proceeded to look at me and laugh at his own joke.

Noah was transferred out of the ICU to the Neuro DOU -- a HUGE step forward. Noah has his own room (thanks Dad! -- this took a little Bob Fell rhetoric); a window; a room with light; his own bathroom... and he's thrilled. He has been extremely anxious to leave the ICU -- confiding with my mother that he had seen too many bad things occur around him in the ICU and was ready to leave.

I can't describe my own joy in sharing this picture with everyone... notice Noah's thumb is up at the very bottom of the photo... and the sign on the top right that says "No Bone Flap on Left" (he still is missing a piece of his skull on the left side):




Photo credit: Lailan McGrath

GO NOAH!!!

A Special Thank You

Noah's medical team has been extraordinary; but we would be remiss if we did not give a special thank you to Dr. Peyman Tabrizi. He could have given up on Noah upon the advice of others who thought there was absolutely no chance. But he said, "This boy is 22 years old; let's give him a shot." There are no words to express our gratitude, so we'll simply say "thank you." WE LOVE YOU DR. TABRIZI! Noah will give you a kiss shortly!

Saturday Morning

12 days ago, when Noah arrived at the hospital, the emergency nurse who admitted him couldn't decide whether or not to write DOA ("Dead on Arrival") on my brother's chart. Late last night, Noah turned to me and said "Louie, I think I'm going to make it." And proceeded to ask me, Uzo (a male Nigerian sitter), and Angel (his gay Filipino male nurse) for a kiss.

Noah counted to ten yesterday; he told my parents that it was "weird to see them together" (ha!); he asked me to pound it (bump fists); he looked at a picture of a friend and said "he's the man;" he refused to go the bathroom until they brought a bedpan (yeah!); and he even tried to convince me that the doctor had told him while I was out of the room that he could leave the hospital... "Louie, let's get out of here!"

We've got a journey ahead of us, but Noah is a living, breathing, and now talking miracle. Go Louie, er Noah, Go!!!

Friday Morning

Yesterday turned out to be quite an eventful day. Noah is talking up a storm. He's having a tough time remembering things -- and he is having some trouble speaking. That said, when his mother walked into the room, he said "Mom! Where have you been!" and when his father walked into the room, he said "Dad, I love you." Of course when I walked into the room he said "Louie, unlock these!" (he's in restraints). And I had to say... "Noah, I'm your brother Adam." He didn't really understand that (he spent 6.5 hours calling me Louie), except for one moment when he got mad at me and said "Adam! Stop it!" (I proceeded to dance around the room with joy, but 3 minutes later he called me Louie again... and proceeded to for the next 5 hours). To give some context, Louie is Noah's close friend with whom Noah was playing video games the night before his rupture.

Noah continues to be extremely restless, having not slept a wink last night. He still cannot tell us what year this is nor hold up 2 fingers, but what amazing progress from where we were!

Everything is moving in the right direction -- we now need everyone's thoughts to push him to the next level. Let's hope that confusion gives way to clarity; clarity gives way to articulation. C'mon NOOOOOOOOOOOOOOOOAAAAAAAAAAAAAAAAAHHHHHHHHHHH!!!

Noah is Speaking

Noah Fell just looked at me, his father, and his mother and said "I'm cold" and "I'm tired." It's an absolute miracle.He's still very, very out of it, and we are still not out of the woods -- but we can definitely see the light through the trees!!!

Thursday Morning

Day 9: Today brought more good news! Noah is obeying commands for the first time in his life!

We are still not out of the woods. We may have to install a cerebral shunt if Noah does not begin draining his excess cerebrospinal fluid and possibly a feeding tube because Noah is not digesting his food.

However, all signs are improving and for the first time, we are beginning to feel we are on the way to recovery. Bless you all for your thoughts, care, and positive energy that you have bestowed upon Noah.

Wednesday Evening

There isn't much more to report this evening. That said, tomorrow will be a very important day as Noah will be taken off of all sedatives (even the pentobarb is now more-or-less out of his system) so we can see if Noah will respond to commands and whether he can breathe on his own.Obviously, we're excited for tomorrow and appreciate your continued prayers as we head into such an important day. E Kawika malama pono!!!!!!!

Wednesday Morning

Day 9: Dad: "Morning brought the joy of Noah opening his eyes and the difficulties associated with his partial awakening. Noah had to be sedated and his arms restrained because he wants to take the tube out of his throat-- that boy can't stand to be annoyed! Noah is definitely on the road to recovery, and when he can take "commands," Noah will be allowed to breathe on his own and we will be well on our way.

We are not allowed to see him directly nor talk to him because he gets agitated. He has no idea how much we will agitate him later on!

Your love and support is working; keep it up! We continue to remain optimistic and so very thankful for the love expressed consistently throughout this difficult ordeal."

Tuesday Evening

Noah is moving. Mouth, throat, hands, legs, and even some eyes -- it's a miracle to watch. He is still very sedated, and he is not yet conscious; however, it is wonderful to watch him move. Noah's neurosurgeon is very encouraged by his numbers, and feels he has an 80% chance of remaining free from hydrocephalus. Noah also had an EEG scan this morning, but the results of that test remain to be seen. The brain catheter that monitored his ICP has been removed because they are comfortable that his ICP is stable. Noah's fever and diarrhea seem to be more under control, but we still await the results of the stool culture we took this morning-- just to be safe. One thing we learned this morning from the doctor is that until Noah's level of pentobarbital is below an index of 10, we shouldn't expect much conscious activity. 2 days ago, Noah's level was at 43. Yesterday it was at 31. We won't know what level it was at today until tomorrow morning. Again, we cannot express our graditude for all of the wonderful gifts, thoughts, prayers, positivity, assistance, supportive phone calls, and visits. We are looking forward to tomorrow.

Tuesday Morning

Day 8: Noah's temperature elevated somewhat last night, but they have sucessfully brought it back down. He is now shivering again, which shows an automatic reflex (a good thing).Noah still has elevated levels of pentobarbital in his system, so his emergence from sleep will take longer than today. We're all so terribly appreciative of your thoughts, positivity, and prayers; we are all fighting together to hold him in the light. E Kawika, makaukau 'oe, e ala e!

End of Day, Monday

We continue to make progress. Noah got the shivers this afternoon (something we were told might happen) and he has coughed about half-a-dozen times now. The doctor decided against a tracheotemy (sp?) as he hopes Noah will be able to breathe on his own. Noah remains on no sedatives, and we expect more movement tomorrow. That said, Noah's blood test this morning still showed very high levels of pentobarbitol in his system, so the process of waking up will continue to be very slow and gradual. We pray for clarity and the opportunity to tell Noah how much we love him-- no matter what the next couple of days brings. C'mon Noah - c'mon!!!!

Monday Morning

Noah coughed at 3:06am last night. How thankful one gets for small steps in the right direction. He has had a lot of sedative in his system and we will have to wait for the next 15 - 24 hours to see any movement- which will be very minimal at first.

We remain hopeful and optimistic and we know your thoughts and prayers are working.

Mid-day Sunday

Today came with more positive news-- unlike yesterday, Noah is beginning to digest his food, and they have begun feeding him again. They have taken him off of all sedatives for the time being so they can look for some movement. That said, the nurses have been clear that it can take some time before the pentobarbitol leaves the system (we've heard anywhere from 24 to 72 hours, or more).Noah seems to have the pnemonia and other respiratory complications relatively under control--and we hope that will remain stable. There are a lot of things to be grateful for, and we now begin a very important new stage in this process as we wait for Noah to wake up. Let's go Nooooooooaaaaaahhhhhh!!!!!!

Saturday End of Day

All news remained relatively positive through to the end of the day today. Noah has been taken off of the original heavy sedative (pentabarbitol)-- and we are beginning the slow process of waking him up-- which could be a couple days or many days--depending on how things go over the course of the upcoming days. C'mon Noah!!!

12:30pm, Saturday

Mom gets a chance to rub Noah's feet. Photo credit: Bob Fell





This morning came with more encouraging news. Noah's ICP (brain pressure) levels are considerably lower (which is desirable), and all of his other vital signs seem to be stable--considering. Furthermore, his oxygen saturation remains close to 100%, despite the fact that they've lowered the 02 concentration he is breathing from 90% to 45%. This is all very good news. Lastly, we met with the Neurologist today, who is encouraged by the CT scans and who remains hopeful that if we can rebuild Noah's health to a point where we can wake him up, that damage might be less than originally thought. We remain very hopeful. Lastly, we learned that Noah has been taken off of pentobarbital anesthetic and has been put on propofol as a prelude to hopefully waking him up and taking him off the ventilator -- another step in the right direction. We also seem to be making progress on his pnemonia and the secretions from his lungs are less in volume and viscosity. The Pulmonologist also decided that he did not need another bronchoscopy today. Noah's doctor is very clear that we are not yet out of the woods; however, we are encouraged by Noah's progress. Thank you all again for your love and support; it is clearly helping Noah.