Update #40

From Lisa:

Nick went to church for the first time last Sunday, August 26th. While he was happy, he was also trying to figure out where he fits in now. Nicholas has always been one of those kids who is out playing football, games and rough housing. Now he has to learn how to reach out and have fun from his wheelchair and others need to learn how to reach out to him. It will take time but I'm sure he will do it. He has a great sense of humor and a tender heart going for him.

Nick was also sick on Sunday. He was vomiting throughout the day. This has been going on for a few weeks - ever since his g-tube was taken out. His blood pressure has also been bouncing about so his Dr. decided to run some different tests during the week. He had an upper GI, renal sonogram, echo gram and an o2 sensor for a couple nights. We received the results of those tests and his MRA (like an MRI but with dye injected to show the blood flow through the arteries) and all of the tests came back negative.

Also God healed the dissected artery COMPLETELY! He has 100% blood flow through that artery again! He will be taken off lovinox (a blood thinner) and put on aspirin. So while all of that is wonderful news, we will be leaving the hospital this Friday, Sept. 7th with no answers as to why Nicholas had a stroke. This is very hard for me. I want answers. The doctors at Children's have been wonderful. They listen patiently as we ask "what about this" questions, but there just aren't any concrete answers. My oldest son says God is trying to break me of something. I know he is right. There is this fine balance of doing everything you can for your child and trusting God with what you can't control. "Be still and know that I am God." Psalm 46:10

We had a great meeting with the Rehab Team at Children's and with Nick's principal and school speech therapist. Dwight and I left there feeling so blessed to have so many people supporting our son and helping us to take this step by step. Nick will have at least 1 week between discharge from the hospital and starting back to his school (yes the school he was attending before the stroke). This is an amazing undertaking for the school! They could turn him away and have him go to a school "more suited" for him, but they have taken the attitude that they can be a very important part in his rehabilitation. They are getting him an aid, a lap top, possibly an occupational therapist at school, adjusting his schedule, and whatever else he might need - just for Nicholas. I will also be attending with Nick (more of a fly on the wall) to help with his transition.

Our family continues to be amazed at the kindness of so many people. Thank you!! My eyes and heart well with joy and tears and I keep standing in awe at what God has done and continues to do.

Lisa

Update #39

The Brinkerhoffs were told today that Nick is being released from the hospital and fulltime rehab on 9/7.

They'll meet with all his doctors on 9/6 to discuss their recommendations for what's next - what kind of rehab, how long, etc.

They requests prayers for discernment as they'll have a lot of decisions to make at that time.

Nick is SO excited to come home!

Because of his advancements, life should be a bit easier than the last time he was home. But there will still be many challenges.

The El Cajon Posse has offered to come in and make modifications on the house to accommodate Nick's wheelchair. Hopefully they can get that done before the 7th.

Nick's doctor sent some of his blood to the Mayo Clinic, but the results aren't helpful in trying to determine the cause of all this. Children's just did some scans to see how the affected artery is healing. They should have results in a week.

Nick's improvements continue to be gradual - speech and movement slowly advancing.

Dwight and Lisa wanted us to see some photos of Nick's progress - an awesome picture of God's powerful, merciful hand at work in the life of this wonderful young man:

With his sis

Off the respirator!

First wheelchair ride

Just out of ICU

Smiling!

Thumbs up after his first pizza

Tearing up the halls on the trike

Update #38

Nicks’ a star! He appeared on a local newscast this weekend when the World’s Smallest Horse came to visit the kids. You can see the video here.

His progress continues to be gradual. They’re mostly working on strength and endurance conditioning.

He can now take 3 or 4 steps on his hands and knees with no help! He’s up and walking every day with the bars for balance, which he has very little of still.

He got to go home Friday for 4.5 hours for his brother, DJ’s, birthday. He went in the pool and had a great time.

And you can still help the family! Gift cards, gift cards, gift cards! Please either take them or mail them to the church:

Community Covenant Church
ATTN: Brinkerhoffs
1835 Granite Hills Dr
El Cajon CA 92019
(619) 447-2675

FOR FOOD:

• Costco
• Vons/Safeway
• Whole Foods (only available in stores)

FOR GAS:

• Arco
• 7/11: You can buy a Convenience Card at a store and put any amount on it

Update #37

From Lisa…

What Nick’s been up to:

Nick had been bugging his doctor to take out his feeding tube - he even tried to bribe him by telling him he would wash the doc's car! So the doctor had his g-tube taken out last Thursday right there in his bed! I videotaped the whole thing. He had a hole about the size of a penny in his stomach. It's closing up but he has been sick everyday except Sunday. They aren't sure why. Oh, and he didn't have to wash his doctor’s car.

They sent off blood work to the Mayo Clinic to see if he has any underlying cause for the stroke. Nothing was found. They decided to run a couple more blood tests, so we will wait to see.

He can feed himself 75% of the time (his hands shake). He can also make a phone call, ride a trike, and tie his shoes pretty well. Amanda and I do 7th/8th grade math and English with him.

• 14 weeks and 6 days ago Nicholas had his stroke.
• 5 weeks and 2 days ago he started talking.
• 3 weeks and 2 days ago he returned to rehab.

These numbers blow me away! We are amazed at the healing that God continues to bring Nicholas each day. And along with it, a beautiful attitude and spirit. Day after day he tackles his goals with a smile and determination. Whatever he accomplished yesterday is not good enough for today - he wants to work on the next goal. As I watch him learn to hold a fork, learn to stand, put one foot in front of the

other, turn a page in a book, or practice the /s/ sound, I am in awe.

I never realized how much I took for granted. He is such a miracle.

Three years ago Nick played football. I asked him what was harder - hell week or his healing process? He said healing is so much harder!

Last week Rehab received a trike for the big kids - this is Nick's new favorite toy! The first day he wobbled through the halls, but the second day he looked like he had been riding awhile - just like being on a quad! :) When his physical therapist asked if he was tired, he said, "No, I'm dead tired!" This is now known as Nick's Famous Quote in Physical Therapy.

Nicholas is not the only one that surprises me - D.J., Amanda, and Connor are also quite amazing.

In May, when Nick had his stroke, D.J. and Amanda continued to keep up their school work, take tests, do projects, travel back and forth to the hospital, deal with their feelings and still ended up with excellent grades (all A's & 1 B). Through the summer they made their own travel arrangements (by plane, train and bus) to visit family, colleges and went to camp (thank you to everyone who helped with the housing and financial end of their adventures). They help care for Connor, hang out with Nicholas, and run errands for me.

Before Nick was sick, Connor's job was to wake up Nicholas every morning. The other day he looked at Nick’s bed and in a sad, longing voice said, "Oh, JoJo's at the hospital." (JoJo is what Connor calls Nick). Connor has learned about loss. And he has learned about gain with all of the new people in his life. He has also learned how to make the hospital a playground!

But the greatest gift I have received is watching all 3 children love and accept Nicholas no matter what their brother's abilities have been. From the first days of the coma, they have talked, prayed, read and played music for him and they continue to find ways to make him feel "normal."

How can one mom be so blessed to have four courageous angels?

MORE…

This is from Rick Padelford, who works at San Diego Imaging – the surgeon who initially worked on Nick works there as well:

I just got a note from Dr. Clint Nichols, the interventional radiologist who operated on Nick. Dwight and Nick came over to the hospital this weekend to see Clint and he just happened to be on call. Clint was literally speechless. He said that he got so choked up that he couldn’t say anything.

He was so stunned with Nick’s progress and it meant so much to him that they came by.

A lot of our physicians in the practice have been tracking his progress….Some through the blog. He is one of those amazing cases that come along once a decade.

Update #36

After two solid weeks in rehab, Nick is making slow but steady progress. (Remember the tortoise analogy?) For instance…

• They have Nick standing and walking every day now, using the bars or a walker. They continue to work on building up his stamina.

• He’s able to sustain himself with food now, so they’ll be taking his feeding tube out soon.

• His dexterity is increasing, as he can now put his clothes on, but can’t do buttons or zippers yet. His arms are steadier and he can also move his thumbs much better.

• His speech progress is slow but steady.

The doctors are encouraged and Nick’s spirit continues to be strong and resilient.

By the way, they were able to get a van that accommodates a wheelchair before he went back into the hospital. They took him to go see the Transformers movie and he loved it! It’ll come in handy when they’re able to temporarily take him out or home for the weekend.

Thanks to all for your continued support and prayers!

Mike

Update #35

Nick had a great first week in rehab! He’s a real champ and working hard. He’s very driven and focused. And this ain’t easy stuff they’re putting him through.

He’s getting strength faster in his legs than in his arms. So they’ve been getting him in a walker to learn how to stand and walk again.

But his arms are also gaining strength. They’ve put him in a manual wheelchair and he can wheel himself down the length of one hallway before he gets too tired. Plus he’s feeding himself more and more!

He still has to eat soft food because his throat and mouth muscles aren’t fully functional yet. But he did get his pizza the other day!

Nick gives a thumbs up after his pizza!

Dwight and Lisa have noticed that his hearing and sight is more acute. He did great at a cognitive test and will be taking a grade-level test this week to see how much he’s retained.

Of course they’re back on the rotating schedule of someone with Nick at all times, so that brings its own set of stresses and such.

Last week Lisa told me that Nick wanted to see the Atkinsons. So we went in Thursday late afternoon. It was SO cool to see him. (The last time we saw him was just after they moved him to rehab from the hospital.) He’s come SO far! He was talking and laughing with us. It takes some work to understand him, but it was great to hear his voice.

The coolest part – and the fact which shows that Nick really is in there – is that he can still differentiate our twin boys, Jeremy and Joshua. (He’s one of the few people who can.) He still knew which was which. Just blew us away!

There’s a group of business people in East County of San Diego called the El Cajon Posse. They help out families with needs, and they’ve been awesome with the Brinkerhoffs! They’re putting air conditioning in the house, they donated money (along with other folks) toward the wheelchair van, and they’ll be putting ramps and wider doors in the house. (Of course, we hope those are ultimately unnecessary!)

And you can still help the family! Gift cards, gift cards, gift cards! Please either take them or mail them to the church:

Community Covenant Church
ATTN: Brinkerhoffs
1835 Granite Hills Dr
El Cajon CA 92019
(619) 447-2675

FOR FOOD:

Costco

Vons/Safeway gift cards

Whole Foods (only available in stores)

FOR GAS:

Arco

7/11 (gas): You can buy a Convenience Card at a store and put any amount on it

Update #34

From Lisa, Nick’s Mom, written last night:

Well, we had Nicholas home for 16 days, a much shorter time than we anticipated (we had hoped for the summer). When we first told him that he would be returning he did not want to go and then it changed to not wanting to sleep there, but the last couple of days he started counting down. He is determined to eat, walk and talk . Of course, he will also be learning all of the daily living skills needed.

Today he arrived at the hospital about 10 am and was evaluated throughout the day by all of the doctors and therapists. Speech was so impressed with his swallow that they allowed him mac -n cheese and peas for lunch (he never used to like peas:)) and spaghetti and green beans for dinner. For now his food is diced but he really does not care! They will continue to work with him on different foods and nothing could make him happier.

Everyone wants to know if we are happy about his progress. Of course we are, but at the same time we are still processing what has happened to our son over the past 13 weeks. We have gone from saying goodbye to our son, to each day being in awe as God continues to keep his promise to me and heal him. It is a strange place to be for me.

I am dealing with the loss of who Nicholas was before the stroke and praising God as he knits together a new creation right before my eyes.

I will be honest to share with you that for me it has been easier to be a part of Nick's journey, and to believe without ceasing, than to be a part of my own. You see, a week before he had the stroke my family was hit with another crisis. We were unable to even begin to process it when this happened. But God has a way of not letting things go and it must be faced. While I don't believe God did any of these things he did allow them and for some reason in this order. As I said, believing God for Nick's healing was never a question for me, but now my faith is being challenged in a way that I don't think I can stand up to. After all we have been through I should be able to walk through this desert and cling to my God without any doubts.

Pride gets in the way. How can I allow God access to certain parts of my life but not all? I am sharing this with you for a couple reasons. 1) In my 40 yrs. (isn't that how long they wandered the

desert?) I have learned that I must always be real 2) and so I humbly ask for prayer for me and my family 3) I also just want to encourage each of you in the work God has been doing in yourselves.

When you are in the middle of a crisis it can be easier to call out to God, but as the days pass and the crisis isn't so intense, we can get lazy and go back to our old ways.

May God continue to rehabilitate each of us no matter what our handicap might be.

Thank you to each of you, for the love and support you have so unexplainably shared with my family. I have been so negligent in proper thank you notes, but please know that we have cherished every prayer, card, meal, gift card, phone call, house cleaning and many other gifts. THANK YOU!

Lisa

From me, Mike:

What an amazing spirit Lisa has. It reminds me of an article I read yesterday. It’s written by Tony Snow, the White House press spokesman, about his bout with cancer. Maybe you’ll be encouraged by his words in conjunction with Lisa’s:

Cancer's Unexpected Blessings: When you enter the Valley of the Shadow of Death, things change.

Update #33

More great Nick news!

They had an appointment with the rehab doctor today and he was so impressed with Nick's progress, he’s bringing Nick back to the hospital for full time rehab starting Monday! So he'll live there full time for a few weeks, and then he’ll be allowed occasional home visits. This rehab program will probably last about three months.

The doc really wants to capitalize on Nick's growing control and strength. While his development has been in big leaps the last couple of weeks, it will most likely be more gradual now.

Here's a summary on Nick's progress since the last update:

• they can see his strength returning, as he continues to roll around on his mats and doing some leg lifts and getting into a sort of push up position
• he can better control his limb movement
• his speech is getting clearer
• he's eating more and more soft foods (soup, jello, ice cream, etc.) and is gaining weight
• he's developed a great, dry sense of humor - this has been so encouraging to the family!
• while he has some good mid- and long-term memory (like friend's phone numbers), he struggles with short-term (for instance, a little while after their appointment today, they asked how he thought it went and he answered, "What appointment?")

Since he can communicate so well, he's been asking what happened to him. He wants to know if he'll ever be normal again. So they've been able to process this tragedy with him.

Believing in miracles...praying for "normal"

Update #32

Nick is now speaking in sentences! 6-9 words long!

He's able to repeat what's said to him as well. They are slow, slurred words, but they can understand him.

Plus, he's asking for food. For instance, he told Lisa, "I can handle pizza." (Ha! Is that a 13-year-old or what???) Of course, he can't handle pizza yet. His body would not react well at all to it. He's basically eating only pudding, applesauce, and ice cream.

He's continuing to make better connections with moving his body. For instance, he can better differentiate side to side movement.

His nurse said these progressions would come in bursts and to take advantage of them. So Lisa and Dwight are doing a lot of work with him.

Update #31

Nick has been home a few days now, and lots to report!

It's been a big adjustment for Lisa and Dwight, as Nick requires constant care that others use to do (in the hospital). That, along with the constant care needed by Connor, has been a juggling act. They feel like it'll take a couple weeks to adjust to it all.

After they got him home, they decided that Nick needed a place that he could move around on his own. So Dwight got a couple tumbling mats at a sporting goods store. They lay those in the living room and put him on them. At that point he can move and stretch and wiggle all he wants...which he does! And they can get down on the floor to work with him.

Plus, Nick has found his voice! He can speak the following words:

• Mom
• Dad
• Hi
• Bye
• Nick

Is that cool, or what???!!!

He's also able to move his head, which means they can ask Yes/No questions and he can answer with his head movements! They feel like he is now fully cognitive.

Through those Yes/No questions, they've also determined that he can read fine. And he can add, subtract, multiply, and divide.

Wow.

They're also trying to expand his taste buds. He's doing pretty good with a sucker.

To start rehab, he'll need to develop some stamina, which he doesn't have now.

They're currently looking at a van to accommodate a wheelchair, so they can get Nick around.

The family is so thankful for everyone’s support! They ask for continued prayer for strength and courage. Every now and then they can tell that Nick is struggling with all this. They're doing the best they can to comfort him, but it must be so hard.

HOW YOU CAN HELP

Let's keep that constant stream of gift cards to the family for food and gas. I’ve listed the ones needed below. Please either take them or mail them to the church:

Community Covenant Church
ATTN: Brinkerhoffs
1835 Granite Hills Dr
El Cajon CA 92019

(619) 447-2675

Here are the main places they go:

FOR FOOD:

• Costco
• Vons/Safeway
• Whole Foods (only available in stores)

FOR GAS:

• Arco
• 7/11 (gas): You can buy a Convenience Card at a store and put any amount on it

Update #30

Got an email from Nick's mom, Lisa, this morning. It's makin' for a very good day! Here you go:

Nick is smiling! (See photo below.) He is also making a kissing face. He's coming home today.

Update #29

Some big changes and news to share this time around…

They’re starting to see good progress in Nick at least every other day! Getting stronger, more control, etc. For instance:

• He can now control both eyelids separately, which means he can wink
• His right arm is getting stronger
• He’s starting to control his left arm better, and his left hand is getting a stronger grip
• He can curl the toes on each foot separately
• He’s getting more movement in his legs

So the doctors have decided that they want to send Nick home. They’re encouraged by his progress and want it to continue so that he can return stronger to rehab a more active participant. The amount of time is a bit open ended, but they think it will be 1-2 months. Then he’ll start a rigorous, 3 hour a day rehab program.

Please pray for Nick that he doesn’t get discouraged, as he’ll need a lot more strength and stamina for that tough program. For now please pray for the family as bringing him home will bring a whole new set of challenges. If they need particular help, we’ll let you know.

Dwight and Lisa want to thank everyone for their prayers and support throughout. They are very touched.

I just happened to be listening to Alison Krauss’ song “In the Palm of Your Hand” as I was writing this update – here’s a relevant passage of the song:

I'd rather be in the palm of Your hand
Though rich or poor I may be
Faith can see right through the circumstance
Sees the forest in spite of the trees
Your grace provides for me

THE NICK BRACELET

The Brinkerhoffs had some cool bracelets made up to help us remember Nick. They’re like the Live Strong bracelets, with Nick’s name, the date of the stroke, and the phrase “Believing in a Miracle.” If you attend CCC, you can get them at the What’s Up booth. If you don’t, you can mail a self-addressed, stamped envelope to CCC and we’ll mail one back to you. The bracelets are free! If you mail to request it, make sure to note how many you want, what color (black, red, or light olive green), and what size (medium or large):

Community Covenant Church
ATTN: Nick Bracelet
1835 Granite Hills Dr.
El Cajon, CA 92019

Thanks!

Mike

Update #28

The long, slow, grueling world of rehab has begun for Nick. What this means is that progress will most likely be in infant steps (yes, smaller than baby steps), and updates may be less often. But we'll certainly keep you in the loop!

He's in a private room now in the rehab wing at Children's. The team there is working with him on his trunk/torso and neck muscles, and they're seeing good, but slow progress.

He's definitely controlling his tongue more, even on command occasionally. He can turn his head on command, which is great. But he can't respond with Yes/No yet (like, move your head to the right if yes...).

More later…

Update #27

Nick has been moved to the Rehab unit at Children's Hospital, even though he's not in a typical state that they would start rehab. So he's running a bit under the radar there. His regular doctors are still working with him, and some rehab staff have started to as well.

Dwight and Lisa met with Nick's medical team yesterday. Overall they are very encouraged with his subtle progress. He's definitely not in a coma anymore, so they're starting to get a better read on his abilities.

Nick is definitely awake and can track the movement in the room. At times it seems like he's trying to speak, but can't. But his tongue does have more movement. He can also move his arms, but it doesn't seem like he can control them - like he can't reach out and grab something.

One of the most important steps in the rehab process is getting Nick back on a regulated sleep schedule. They basically have to retrain his body to sleep correctly again. (As with any part of life, sleep is so important to our health.) So yesterday they started him on a Melatonin program, which they hope will normalize his sleep cycle.

He definitely seems to be gaining more movement and control over time - but it's very slight. (Remember, this is the Tortoise version of the race, not the Hare!) It's going to be a very long road to recovery.

The doctors will not guess how this will turn out, because (and they admit this) they just don't know. There are so many factors involved that they cannot predict.

What we do know is that between the doctors, his angels, and the great cloud of witnesses, he has the best care in the universe.

Update #26

Nick is still progressing well – baby steps of improvement…

For instance, he’s moving his head back and forth quite a lot and he can move it on command! He is still tracking movement with his eyes but they’re not sure just how much or how clear he can see.

He’s sticking his tongue out even farther, and there is slight movement in his toes, although not on command.

The neurologist has been checking his reflex (ya know the hammer on the knee?) the last few weeks and Nick recently showed signs of reflex for the first time!

He’s being pushed around the ward in a wheelchair twice a day.

They have moved him out of the Intensive Care Unit to Intermediate Care. That’s caused a bit of stress, since the care isn’t quite as acute and it’s a whole new crew to get to know. The good thing is that they moved him because his vital signs have all stabilized! For instance, his body temperature and blood pressure are being regulated by his own body.

This week there will be a big meeting with Nicks’ whole medical team (critical care doctors, neurologist, social worker, rehab folks, etc.).

HOW YOU CAN HELP

Thanks to so many helping with child care, house cleaning, meals, and more! And Dwight REALLY thanks the anonymous person who mowed his lawn today!

It would also be nice to have a constant stream of gift cards to them for food and gas. I’ve listed the ones needed below. Please either take them or mail them to the church:

Community Covenant Church
ATTN: Brinkerhoffs
1835 Granite Hills Dr
El Cajon CA 92019
(619) 447-2675

Here are the main places they go:

FOR FOOD:

Costco

Vons/Safeway (not Albertsons)

Whole Foods (only available in stores)

FOR GAS:

Arco

7/11 (gas): You can buy a Convenience Card at a store and put any amount on it