Update - 6/29/06

Last week was a very good week for Matthew - he was expressive with immediate responses, saying words, and eating well. When one of the therapists left the room, she waved goodbye to Matthew and Matthew waved back. Another therapist (it may have been the same therapist) was talking to Matthew about giving him something for the pain and she made a statement like, "would that be all right, Matthew?" and he responded with a clear "all right". On Friday when Pastor Kurz was with Matthew, he was standing on the other side of the room and decided to see if Matthew would wave to him. He asked Matthew to wave and Matthew waved back. Then he asked Matthew to make a clenched fist like he was doing and Matthew responded with a clenched fist like his dad's. Pastor Kurz had him make other hand motions with his left hand and Matthew responded in turn. Matthew also started to show more expression in his face (both positive and negative).

Things have not been so great this week. Monday afternoon, Matthew was unresponsive and they couldn't rouse him. His heart rate dropped and his blood pressure was low. He isn't eating again and he wasn't able to relieve his bladder. This went on for a couple days. They ran blood tests and scans and everything looked fine, within normal levels. They believe the level of the baclofen pump was too high (for his muscle tone) and he was dehydrated again. So, they have been giving him extra fluids and decreased the level of the baclofen. He is starting to respond a little more and getting color back into his cheeks. Consequently, because of this setback, Matthew's release date from Rusk has been moved back to July 5th (tentatively).

Andrew is off the crutches and has a new knee brace. He has also been given a new medication for inflammation and that seems to have helped, so his legs are feeling much better. Andrew will soon be going on a mission trip in July with folks from Trinity Lutheran Church in Cole Camp to Mexico. They will be building a house for the needy.

Hope you have a safe and enjoyable 4th of July weekend.

Rachel Asburry
Matthew's godmother

Update - 6/22/06

There have been alot of positive things happening this week to share with you. The week began great on Father's Day. The whole Kurz family was together, as well as the Asburrys and dear friends in Columbia, the Thiemes. We spent most of the afternoon and dinner time outside and it was easy to see that Matthew was content and enjoyed the outdoors. We had an impromptu picnic under the gazebo and Matthew ate well. It was enjoyable to be together and the dads had a great day with their children.

A couple days later Matthew got to stand! Now, Matthew wasn't able to make any effort to stand on his own. The staff was working to get him upright and held him up with great assistance. It took alot of effort and there was pain for Matthew because of the tone in his legs, but he was upright for a few seconds and when they sat him back down, Matthew had a pleased look on his face.

Yesterday, they took the bandaid off of Matthew's foot because the wound has completely healed. He is now wearing a shoe on his left foot for the first time in a long time!!!

Matthew was given a marker to hold in his left hand. He adjusted the marker in his hand like he used to do and then made a mark on a piece of paper on his lap. Then, with his mom's help assisting him, he drew a circle on the paper. It wasn't an even circle by any means, but it was a circle!

Matthew's eating has improved some more. He is now eating from a spoon (with someone else feeding him). Previously the food had to be inserted in his mouth by someone else's fingers. He is opening his mouth a little wider and making it easier to get the utensil in his mouth.

As of this writing, Matthew is still scheduled to be released from Rusk Rehabilitation Center on June 30th and will be moved to his grandparents' home temporarily.

The Lord be with you!

Rachel Asburry
Matthew's godmother

Update - 6/16/06

A couple days ago Matthew had a rough night. He was taken to the emergency room at 1:00 a.m. because he was very pale with an irregular heartbeat and they couldn't arouse him. They kept him for several hours trying to figure out what was wrong. One problem they did discover was that he was dehydrated. So, they got an IV going, but that was also difficult. They had to reinsert the IV several times because his veins would "blow out".

After hours of resting and getting the fluid his body needed, Matthew's color started coming back into his cheeks and his system normalized. He also had a clearer look in his eyes rather than the "haze" he appeared to be in earlier that day and earlier in the week. When one of his therapists came in the room, he turned his head quickly and appeared to be listening intently to the conversation. Rev. Kurz and the therapist also noticed a slight movement in Matthew's right hand and what felt like a little squeeze.

Next the speech therapist, Jen spent time with Matthew to work on facial movements. She asked him to stick out his tongue at her. His dad helped him a bit by nudging his chin down and then Matthew opened his mouth wider than he has lately and stuck out his tongue! She asked him to do this again several times and it looked like Matthew was trying to move his tongue around or make the effort, but he didn't do it again. Jen also wanted Matthew to make an intentional movement with his left hand (rather than the active involuntary movements he makes). She asked him to touch the top of his head with his left hand. Matthew lifted his arm and then touched his head and kind of ran his fingers through his hair. His dad said "looks like you did it, Matthew" and then Matthew said "yeah"! It was a clear and audible "yeah" - not a moan or grunt. How exciting!

After these accomplishments, Jen rushed out to tell the other therapist who came back into the room and asked Matthew to stick out his tongue. He shook his head "no". Guess he'd had enough of performing!

Matthew has pulled his stomach tube out again so they are anxious to get the mickey button in place before he does some serious damage to himself. Hopefully the procedure to do that will take place soon.

The Kurzs have been told that there are quite a few things that Matthew will need when he's released from Rusk that medical insurance and medicaid won't cover. One of those is a shower chair and there are several other items - some that they will probably discover they need right before checking out. Thankfully insurance and medicaid will cover a good portion of the wheelchair, bed and hoyer lift.

Have a great weekend!

Rachel Asburry
Matthew's godmother

Update and Doctor's Letter

I will give you a quick update and then the family has a very important letter to share with you.

Matthew is eating solid foods again - with a great deal of effort and encouragement on his parents' part, but this is good progress back in the right direction. We do not know at this time if Matthew's release date will be extended past June 30th. It all depends on the doctor's accessment of Matthew's current condition (and the doctor has been ill recently).

Flooring is going in this week in the basement at grandmother's house. The carpet was pulled up last week. Volunteers are also working on the driveway and the concrete slab this week. A very generous donation of concrete is MUCH appreciated! At this time a vehicle has not been secured.

The following joint-effort letter was written by a rehabilitation psychologist, and Matthew's Case Manager. It is our hope that this letter will explain a great deal about Matthew's condition and be a reminder that this isn't a temporary change in the Kurz' family's lifestyle and they need all the help and support we can give them.

Rachel Asburry


June 1, 2006

To Whom It May Concern:

This letter is to offer some insight into the nature of the injury suffered by Matthew Kurz. Matthew was involved in a motor vehicle collision on January 25, 2006. Available records indicate that this collision occurred as a result of blinding by the sun that prevented Matthew from seeing a stopped bus, which Matthew's car struck from behind.

Matthew incredibly survived the collision, but suffered a very severe traumatic injury to the brain (TBI). The nature of the injury involved the whole brain, with widespread damage to the axons of the brain (the part of the brain cells that deliver information to other parts of the brain). Consequently, during much of the early part of his hospital stay Matthew was in a coma or near coma.

As is typical in injuries of this severity, Matthew is making very gradual progress. He is now no longer in a coma, and is able to visually establish eye contact with others. However, he is unable to walk, talk, or communicate reliably even in non-verbal ways. He remains totally dependent on others for care, even for activities as basic as feeding himself or brushing his teeth.

Whether he will ever regain the ability to take care of basic activities of daily living such as feeding and toileting himself is not certain, and will not be known for years. Almost certainly, Matthew will be left permanently disabled by this injury. It cannot be assumed that he will regain the ability to walk, and in all probability will need to rely on a wheelchair for mobility.

The rehabilitation team at Rusk Rehabilitation Center, working closely with Matthew's family, is striving to help Matthew regain as much function as is possible. We have found that perfect prediction of outcome after traumatic brain injury is not possible, and sometimes people exceed expectations and make incredible gains. Unfortunately, it is also true that many patients with severe TBI remain permanently and fully disabled, despite the best efforts of the patient, the family, and the medical/rehabilitation professionals.

In Matthew's case there is reason to be hopeful since it is still very early in the rehabilitation process. However, it is extremely important that all involved (directly or indirectly) in providing care and support to Matthew and his family understand that this is a very severe injury from which Matthew will be healing for years. At this stage, all involved should understand that he will be totally dependent for the foreseeable future on those who love and support him. It is not realistic to assume that he will be able to walk any time in the near future, and in order for him to return to the community with his family (where he belongs and has the best chance of healing) it will be critical that the home setting be accessible for a person in a wheelchair.

There is much misunderstanding and misinformation about traumatic brain injury in the general public, often fueled by very inaccurate portrayals of TBI and recovery in the popular media. Unfortunately, these misunderstandings create great difficulties for survivors of TBI and their families. Research demonstrates that one of the best things that can help people recover and adjust to TBI is an understanding and supportive community. This letter is written in an attempt to help create a better understanding among Matthew's home community of the substantial challenges he will face the rest of his life related to this injury. Please do what you can to be supportive and understanding of Matthew and his family.

For those interested in learning more about TBI, you are encouraged to contact the Brain Injury Association of Missouri at www.biamo.org or the National Brain Injury Association at www.biausa.org.

Thank you,

Joseph H. Hinkebein, Ph.D., ABPP(Rp)
Clinical Associate Professor
Rehabilitation Psychologist
University of Missouri Medical Center

Lisa Scott, MA
Rusk Rehabilitation Brain Injury Case Manager

Update - 6/9/06

The procedure to replace Matthew's feeding tube went well (on Wednesday instead of Thursday), but later that night the feeding tube came out. Matthew had a rough night after that, but now he has a temporary feeding tube. Next week sometime they will replace the temporary with a Mickey button (spelling?). It will be a way to seal the hole to his stomach and when it's time to feed him, to "snap on" a feeding tube.

As a result of the troubles with the feeding tube, they conducted a gastro study on Matthew. Everything was fine and in the right place.

Matthew had some good accomplishments in the last two days despite troubles with the feeding tube. He brought a cup up to his mouth three times with some assistance at his left elbow to help him direct his movements. He also was able to put all the pegs in a peg board with alot of effort and more assistance at his left elbow.

Matthew also moved his whole right arm for the first time with his therapist giving instructions! That is a major accomplishment!!!! And despite being tired tonight, Matthew gave a smile to his mom before she left for the night (he hasn't smiled in days).

We are thankful for each little victory!

Andrew is still hobbling around with a large knee brace and crutches. He says it feels a little better but not much. It will take some time for great improvement.

Hope you all have a great weekend.

Rachel Asburry
Matthew's godmother

Update - 6/3/06

The results from Andrew's MRI are in. Andrew has had Osgood Schlatter Syndrome for quite some time and it is very likely that bumping his knee against the dashboard during the accident greatly increased the pain in his knee and made the condition worse. For those of you that don't know what Osgood Schlatter is, here's a definition from familydoctor.org:

Osgood-Schlatter (say: "oz-good shlot-ter") disease is one of the most common causes of knee pain in young athletes. It causes swelling, pain and tenderness just below the knee, over the shin bone (also called the tibia). It occurs mostly in boys who are having a growth spurt during their pre-teen or teenage years. One or both knees may be affected.

So, the treatment for Andrew is to wear a knee brace indefinitely and use crutches for four weeks. In the two days he's been wearing the brace, he's already had improvement and the pain and swelling has gone down. It puts a cramp in Andrew's style for summer activities, but it's much better to give his body a chance to heal.

Matthew's stay at the rehab center has been extended to June 30th. Two of the medications he was on for agitation and concentration had been decreased, but they have discovered they decreased them too soon because of the way Matthew has been acting. So, they will increase the level of the medication back to the previous level, but it takes three weeks for regulating the medication. Rusk cannot release Matthew until the medication is regulated back to where it was.

They also need to continue regulating the baclofen for Matthew's tone. They are working to find the right level for what his body needs. The tone has been very tight in Matthew's legs and it's painful for Matthew.

Next Thursday Matthew will have outpatient surgery to replace the tubing for his feeding tube. They have discovered a tiny hole in the tube. They will replace it with a tube with tiny balloon at the end that inflates and holds the tubing in place (that's not the most accurate description, but you get the jist of it).

Matthew's wound on his foot has almost healed. They would like to try putting him on the tilt table again and also attempt to put him in the ambulator (a machine that will help him stand). This all depends on the muscle tone and the HO (HO has to do with the calcium buildup in his muscles that hardens them). Hopefully they can proceed with this, but alot of this depends on how painful it will be for Matthew.

Matthew's eating has gotten a little better. There is less resistance on Matthew's part and he had more than strawberries the yesterday (baked beans and ribs too! - small amounts though). Brain trauma patients sometimes can't open their mouth to eat because there's an incorrect signal from the brain to clamp the mouth shut. Matthew has managed to get his mouth open a 1/2 inch.

A few days ago Matthew as fitted for a special wheelchair made just for his size and build. This wheelchair is for long-term use. It can be discouraging that the rehab staff are preparing Matthew for long-term wheelchair mobility, but we will continue to pray that Matthew can walk again one day.

Hope you all enjoy warm, sunny days before the intensity and humidity of summer greet us.

O Savior, precious Savior, whom yet unseen we love;
O name of might and favor, all other names above:
We worship you; we bless you;
To you alone we sing;
We praise you and confess you, our holy Lord and King.

(Lutheran Worship, Hymn 282)

Rachel Asburry
Matthew's godmother