details on O’s condition

Saturday 10th March.  After nearly 10 days of bronchial spasms caused by asthma O’s lungs seem better today.  He is breathing partly unassisted.  The original critical asthma attack was brought on by chicken pox.  He is still in a coma and there are no signs of brain activity, only reflex reactions.  It unfortunately is likely that he was without oxygen to the brain for too long for his brain to make a recovery.  He is being visited every day and we are all praying that he will come round and we can enjoy his company again.

Sunday – March 11th O’s condition is becoming more stable and there is talk of moving him from the Isolation Ward within the ICU, to the main ICU Ward. He is breathing partly unassisted but still needs Oxygen on standby. Unfortunately still no signs of him coming out of his coma

Monday March 12th The doctors at Lanna Hospital Chiangmai, which is the nearest hospital to home, have agreed to send an ambulance complete with Doctor and Nurse down to Chonburi to collect O and bring him home. His condition is stable enough to be moved and we all feel he will have a better chance of coming round with friends and family near him. The ambulance left at 18:00 and will drive through the night to Chonburi

Tuesday March 13th At 10:00am the Ambulance began its journey back to Chiangmai. There was a bit of a scare on the way as the oxygen ran low in the ambulance but they swapped cylinders in Tak Hospital after 9 hours and arrived at Lanna Hospital Chiangmai at 22:00. He has been put in the ICU ward and hopefully he will get a good nights rest. There are still no signs of any brain activity, and we have been told that he may stay in the condition he is in and make no further improvements. However we are ever hopeful – miracles can happen, at least now he is home in Chiangmai he will get plenty of visits from his friends and family, maybe we can bring him round from this state. He moves around a bit and his eyes open at times, we are all praying for him.

Wednesday March 14th The hospital has made him comfortable and they are taking good care of him. We are allowed to visit at anytime. His condition has not really changed; he is still unaware of his surroundings

Thursday March 15th Still no change, he was having a mild asthma attack but that is under control.

Friday March 16th No change, his medical condition is stable, hopefully we will see improvements soon

Saturday March 17th Stable but still having asthma attacks

Sunday March 18th Physically becoming stronger, minor asthma attacks, but still in vegetative state

Monday March 19th Today a tracheostomy was performed to make his breathing easier. He is stable after the operation and looks a lot more comfortable.

Tuesday March 20th Looks like the asthma attacks are finally becoming under control, and his breathing is now partially unassisted, there are no signs that he is coming out of his vegetative state

Wednesday March 21st We met with the Doctor responsible for O’s case this morning, unfortunately no good news. He is still in a vegetative state though his physical signs are improving. There seems no chance of a full recovery; the best we can hope for is minor mental recovery, and the need for 24 hour nursing if he can ever leave hospital. It is unlikely he will achieve a life outside of a wheelchair; we are told that frequent visits and physical contact are the best chance of bringing him around from this state, so we will do our best to make sure he has that chance materialize.

Thursday March 22nd We are now at Day 24 since his CPR bringing him back to life after the Cardiac arrest. Today there were vague signs of recognition during a visit, which gives hope. He seems to be conscious during the day and has developed a sleep pattern, the asthma is finally going away and we hope to see improvements in his condition during the next few days

Friday March 23rd No real change, condition stable

Saturday March 24th Stable no improvement

Sunday March 25th At last signs of improvement and hopefully a gradual release from his vegetative state. His eyes are moving quicker and seem to follow movement sometimes when he is awake

Monday March 26th He is nearly weaned off the respirator and looks a lot fitter than a week ago. The hospital really is doing a wonderful job. Now we are hopeful for serious improvement and we believe he has a better chance of recovery than before.

Tuesday March 27th A big improvement today, at midday he appeared to recognize people visiting him, though still unable to speak he can make a response to sound and moves his head when his name is called some of the time. O slept little today and at times it looked as though he was trying to get up. He also became emotional and was crying at one point, very sad but hopefully a good sign.

Wednesday March 28th There have been real improvements but after yesterday with virtually no rest O was asleep most of the day. He has not needed the respirator at all today; we have now reached day 30

Thursday March 29th No more improvement today, mainly rest

Friday March 30th There were more hopeful signs again today and O was quite alert in the early evening. He could clearly see people and was looking around from person to person, and we think he was recognizing people close to him as being different to the nursing staff. Again he was crying at times, normally while he was looking at people he should remember

Saturday March 31st A quiet day, no more progress.

Sunday April 1st Day 34, O had a peaceful day today, no more improvements but he is now off any life support, there is no intravenous drip, he looks comfortable in his sleep.

Monday April 2nd O has developed a sleep pattern where he is awake at night but asleep during the day. There is talk that he could be moved from the ICU in a few days, and the tracheostomy removed

Tuesday April 3rd The Doctors did try to remove the tracheostomy but had to replace it as his oxygen levels dropped. He can now recognize people, and it does look as though he can remember people that were close to him but still he is a long way from recovering to any quality of life. It is likely that he has sustained serious brain damage, it is very sad to think that we will probably never again see the O we all remember and miss. The picture at the top of the page shows his infectious smile which what we hope to see again one day.

Wednesday April 4th There are definite improvements he is more alert and more emotional, his eyes followed us leaving from the evening visit - it was hard to go.

Thursday April 5th Day 38 and today we have seen the most improvement so far. We have all prepared ourselves for the fact that we will never have O back as he was so we are hoping for the next best to that. He was again much more alert today and though he cannot speak or coordinate his movements, his eyes followed us while we were there and we are sure he recognizes friends and family, and seemed to understand parts of conversation. The amazing thing was his fascination when he was shown his mobile phone, only bought about 3 weeks before his heart attack, and his most prized possession, hopefully it triggered off a reaction in his brain. Also he looked with interest at pictures of himself in better days with friends from work. Hopefully he can at least get back some recent memories. He will be moved out of ICU in a few days but is likely to need to keep the tracheostomy in for a fair time. When he is out of ICU we will be able to make sure someone is with him all of the time, and we hope this will help towards the best recovery possible.

Friday April 6th A good day to say the least, O has been moved to a normal room, and will be cared for 24 hours a day. Tonight both Puk and Bank (our staff) are staying with him. There have been quite dramatic improvements I pray they continue, the rocking movements consistent with mental handicap are reduced, and his visual and sound responses are improving. Though he is nowhere near speaking or coordinating body functions it looks as though he could be coming back to us. A few days ago I wrote about maybe never seeing his smile again, tonight he smiled for a few seconds, hard to explain how much a smile can mean but it meant the world tonight. He did not cry as he has been doing and I think he is aware of his situation and that he can get better. Maybe miracles can happen. The staff at Lanna Hospital could not be better, we are so grateful for the care they are giving

Saturday April 7th No real change today,

Sunday April 8th A quiet day, O has company 24 hours a day; normally two people are with him. A nurse is on hand to make sure his medication is taken care of

Monday April 9th The Doctor is now talking of him being released to home care within around 10 days, so we will need to make plenty of preparations. Though he is a lot better mentally he is still very limited in what he can do, he is incapable of controlling his movements and he still has a tracheostomy and a catheter

Tuesday April 10th Still some improvements in recognition, and he seemed really pleased when his younger son Ot (aged 9) visited him today. He does lapse in and out of concentration and we are not sure he understands much about what is going on around him. There is no doubt he recognizes people and is pleased to see them, but we have no positive signs that he can understand what is being said and he does not respond to questions.

Wednesday April 11th O’s physical and medical condition is getting better apart from muscle wastage on his legs which is a worry. There is no improvement mentally and today his spirits seemed down, the only good sign at the moment is that he appears to watch the TV when it is on. He has had plenty of company today and both his young sons spent the early evening with him, he was also visited by friends from Pattaya who had traveled to Chiangmai for the Songkran Festival

Thursday April 12th O’s condition is still stable but it’s hard to notice any improvement in his memory or mental state over the past few days

Friday April 13th Today sees the beginning of the Thai New Year Festival “Songkran” virtually everywhere apart from restaurants and tourist venues will be closed in Chiangmai for the next 5 days. Our offices are closed until April 18th therefore we will not be able to UPDATE co_uk_cocogolf_db.this page again until then

Friday April 20th It is now day 54 - there has been a fair improvement over the past week and O’s condition is now diagnosed as “better than a persistent vegetative state” (PVS). Though he is still on a feeding tube and has a tracheostomy he can now respond to some verbal commands. He is undergoing physiotherapy every morning and has made good progress considering his severe brain damage, he has little control over his movements but can respond by moving the arm or leg he is asked to a little bit, he can almost sit up unassisted and has been standing with support. Unfortunately the Governments financial assistance is about to end and we will need to take him into home care in a few days. It is expected that we will bring O home next Tuesday and we have had to employ two trained nurses for full time nursing care for him, plus equip a room in a similar fashion to his hospital bedroom. We will take him back to the hospital most days for physio however. It is possible that in 12 months we could have him walking under his own power. The main concerns are the tracheostomy and feeding tube, when (and if) they can be removed it will be a huge step. The feeding tube is crucial at the moment because in his current condition he feels no hunger and would not know how to eat or swallow. There have been several times during the past few weeks where we have had to wonder is it fair to have put him through all this, I think we are past the point of worrying about that, it’s the human desire for survival, there is no doubt O is fighting to get better and wants to be alive.

Friday April 27th Day 61 and today we collected O to bring him to stay at home. He is still fitted with a feeding tube and tracheostomy, and will need 24 hour nursing care. His asthma seems to be under control at the moment which should help his recovery. We are also hopeful that staying in a home environment could trigger more improvements. He looks a lot better facially, and smiles a lot, but progress regarding control over his limbs and also mental recovery are very slow. A room in our home has been refurnished with all the equipment needed to make his care possible. Luckily we have two excellent young nurses employed to provide round the clock care. He is also frequently visited by his friends and family. The room has many pictures from his past to try and bring back his memory, he does look at these and they could well help. From now on there is little help from Social Security, and he won’t receive any payments until 12 months, when they are sure he won’t be able to work again. Even then the disability allowance is only expected to be about 2,000 baht per month (around GBP30).

Friday 04 May – O has been at home for one week now, his condition is very slowly improving physically. Mentally there are no real signs that he can return to any sort of life that he had before. He has 24 hour attention and at least his asthma is under control. He still can only be fed by tube and breathes though his tracheostomy. He is helped to sit upright two or three times a day and we take him out for short periods in a wheelchair. Today we took him for a checkup at Lanna Hospital and his Doctor is pleased with his progress and the care he has been given. It will be a very long time before we can see how much we can improve his life. His two Nurses are excellent also Bank, Neng (his wife) and his two young sons are spending plenty of time with him to make him feel secure.

Friday 11th May – It is now 75 days since O’s heart stopped during an asthma attack. He received no oxygen to the brain for around 8 minutes; very seldom people can make a recovery from that, and though people can remain alive in a persistent vegetative state (PVS), the odds of O making this far have been very slim. Progress physically is very slow, but there is progress, we believe we can get him to support himself enough on a frame to be able to walk eventually, maybe in a year. At the moment he finds it very difficult to control his limbs (which can be a bit dangerous for those around him!!) he has very nervous twitchy movements, most of his waking hours. He has two periods out of his bed a day, where he has physiotherapy to help his limb control also he is taken out for fresh air in his wheelchair, and then he is in the main living room in the house to watch TV for a while. Mentally he obviously has very few memories from before his illness, progress is very slow, he has made no attempt to speak, and is still not ready to swallow food so the feeding tube is still fitted. The support we have had from people, by visits, by phone and by e-mail has been fantastic, thank you to everyone for your concerns and for following O’s progress. We all hope that he will recover enough to understand how many people have him in their prayers and care for him.

Saturday 19th May – 83 days on and today was the second return visit to the hospital as an outpatient for O. Progress is still slow but at least there is progress. The Doctor in charge of his case has told our nurses to begin restricting the air intake to his tracheostomy to encourage him to return to breathing through his mouth and nose. This is done in stages starting at 30 minutes and then longer and longer periods until the hole can be closed completely. Then he can return to hospital to have the tracheostomy removed, and the incision into his throat stitched up. We are hopeful that at this time his feeding tube can also be removed. There are signs that he may be able to talk when the tracheostomy is taken away, he is trying to speak at times already. He is getting gradually stronger has a good sleep pattern and looks rested. He has several hours in the living room a day and at weekends his children spend a lot of time with him, they are at ease with his condition and react with him just as they did before which must help him. There is long way to go yet – but considering his condition at the end of February it is a miracle he has got this far.

Friday 25th May – It is 90 days since O’s heart stopped during a severe asthma attack. He has now been at home for 4 weeks. He still needs 24 hour a day care and this week he has been causing problems by pulling his feeding tube out on 3 occasions, each time this happens we need to take him back to the hospital to have it re-inserted. It is understandable that having a plastic pipe in your nose for 90 days must be really aggravating; unfortunately O cannot understand that he needs this tube to feed, and the tube cannot be removed until his tracheostomy is also taken away. Progress is very slow, he is taken out for exercise in his wheelchair and brought into the living to watch TV. But there have been no breakthrough events during the past week, he is a long way away from being able to communicate, walk or feed himself.

Friday 1st June – Only 3 days to go to 100 days of life after death. It’s been a traumatic week with O being rushed back to hospital last Sunday, he was kept in for 2 nights due to a complication with his tracheostomy, which has now been removed, as soon as the scars have healed he will be able to be fed liquid by mouth again and the tube can come out. He has had wonderful support from friends, family and staff which I believe is now accelerating his progress. He was very weak after the two days in hospital and the operation but today he has shown a great will to get better. He is starting to try to talk and amazingly he managed to name several people from photographs who he has not seen for a long while, including a friend he has not seen for more than 12 years, and a few European faces also (notably Mirek who worked for us until 2004, and Richard who supervises our accounting). O spent a few hours being shown old photographs to help stimulate his brain and his memory. His reactions today were more than we could ever have hoped for. Also when we were helping him back to his hospital equipped small room; he gestured towards his old (larger) bedroom and made it quite clear he felt it time to return there. We let him spend a while there and he looked pleased with himself. It is great news to see the brain is working and memories are there, and to see he is fighting to improve himself. Physically he has made small improvements and he is a long way from walking or taking care of himself but at last we know his brain is working again, and though his speech is very handicapped we can understand what he is saying. All in all the best week so far even though it started off badly.

Friday 8th June – Slight miscount on the days on the last update, today is the 103rd day since his heart attack. Progress is being made mentally in particular; he is fully aware of his surroundings, can clearly remember all of his friends and family, and can remember his home environment here in Chiangmai. He has been moved back into his old bedroom, so he is happier there, though a bit disappointed when he realized the hospital bed also moved with him. It is essential he stays in that for much longer, it is much easier to clean and keep free of dust mites which are potentially a danger to his asthma. O always has company and that must help his progress, his children, in particular his two sons spend hours with him and are comfortable around him, they treat him as normal. His speech is understandable though very handicapped; it is good that he can make himself understood. Physical improvement is a lot slower, his movements are uncontrollable and very jerky, and he badly needs to build up muscles and strength. Medically he is still very unwell with asthma and there have been complications from his tracheostomy this week. As I write this his feeding tube is out (as he has pulled it out again) and the hospital have suggested we let him make his first attempt at feeding himself at 17:00 which is his next meal time. If he manages that he at last can have relief from that awful tube, if he can’t we have to take him back to the hospital to have it refitted. If it wasn’t for the pre existing condition of his asthma he would be making a lot better progress, and it is a great worry to us that a serious attack could undo all the progress made so far

Wednesday 20th June – it seems to be 2 steps forward and then one back at the moment. O was making very good progress mentally and speech wise, but there was a setback on Monday and he is now back in intensive care due to a blockage in his throat. He needs the feeding tube again which will be very disappointing for him. He should be out of intensive care on Thursday – we all hope. He still is struggling to build his strength and we are worried that he might have a big asthma attack, which will set him back again. We are hopeful for better news over the next few days.

Saturday 7th July – sorry for the lack of updates in recent days the writer has been travelling. O spent around 12 days in intensive care due to problems in his throat and not being strong enough to digest and gurgitate food properly. He was released on Saturday 30 June and spent the next few days resting as the time in hospital had weakened him further. Since coming home again he has made reasonable progress, still a long way to go strength wise, but he has developed a healthy appetite, and can now eat some fruits and some solid foods, like noodles. He is becoming more alert and though he tires easily is very aware of his surroundings. He is getting plenty of company particularly at weekends when the children are off school. We are now managing with one full time nurse Kung, who takes care of O during the day; other members of the household take it in turns to look after him during the night. It is a bit of a worry how much oxygen he needs, he has been using one cylinder per day, so we have had to hire a much bigger gas cylinder which should last 10 days or more. There is definitely progress, he can talk a bit more and certainly is more aware, hopefully we can get him walking again over the next couple of months, and less dependent on others.

Monday 16th July – it is now 140 days since his heart attack and the following coma. O was taken back into ICU at Lanna Hospital last Saturday as his blood pressure had dropped, he was having fits and also trouble with his breathing. He is now back home and hopefully we will continue with making progress, slow though it is. The main problem is getting him strong, and replacing muscle that he lost during the coma. He is very weak and therefore vulnerable to any illness or infection. Though he is having regular physiotherapy we have had little improvements over the last few weeks. We are still all hopeful that we can get him back to a certain level of self dependence, but that is a long way away at the moment.

Friday 27th July – Day 151 – unfortunately O was admitted back into hospital yesterday, as his Doctor wanted him to be under observation. He has been having uncontrollable shaking fits which makes physiotherapy impossible also simple tasks like feeding him and giving him his medication have become very difficult. Maybe he has been trying too hard and the shaking starts when he tries to move himself. He is very unhappy at being back in the hospital and all he keeps showing is that he wants to come home, he is less co-operative to the nurses and with his limited speech he is making it very clear that he wants to “pai kabahn” go come. We will need to have a meeting with his Doctor soon to agree the next steps, it is also upsetting for all his carer’s to see him unhappy, after having made so much progress.

Friday 10th August – Day 165 – O remained in hospital in a very poor condition for 9 days on the third day he was diagnosed with “Lance Adams Syndrome” which often affect people with his condition. He was having seemingly endless epileptic fits which made it difficult to feed him and administer his medicine. Luckily the new medication began to work after a week, this was a big relief for everyone as the hospital were about to refit his feeding tube and perform a tracheostomy, which really would have been a step backwards. He was released from hospital last Saturday and now is beginning to make a recovery again. He is eating solid food and is progressing; the hard part is getting his co-ordination back and also building his muscles. At this point we are hoping that within a few weeks he may be able to support himself on a Zimmer frame and begin to feed himself also. He has started speaking again – though not as good as he was about 3 weeks ago before the epileptic fits. It is a great shame the LAS (Lance Adams Syndrome) wasn’t diagnosed sooner as we have undoubtedly lost time in his recovery. We have found via the internet a wonderful letter from a young man called Brett Green in America with virtually exactly the same scenario and it gives us great hope to read of his recovery. The letter is below…

“I have LAS and have not had the opportunity to chat with someone with comparable experiences ....and no, you’re right, this is not a contest. I'd gladly allow you to win if I could.

You asked about my story ... it is very long (as yours is I'm sure), complicated, and I don't have the energy or typing ability to explain the full story, but yes ... I have Lance Adams Syndrome (post anoxic action myoclonus). I also have seen the "finest doc's" and have confused many. Facial myoclonus is actually more disabling than action is but none the less; action myoclonus is "crazy".

On June 8th, I had an asthma attack and went into cardiac arrest. Was put into a coma state and came back to life about 22 days later. I laid on my back for another 5 weeks motionless except for the shakes that were unbelievable ... exorcist style.

I then went into rehab in Vallejo, Ca. (great place) in August for about 6 weeks and had in-home health care after discharge for 6 weeks. I am now on my own and re-adjusting my life. I can't walk (yet), I still have those tremors too and my speech took months to get back. I sound like Forrest Gump at times, but what is...is! Although at times, my old voice comes back too. I take Klonopin (only 2mg), Keppra (2,250mg), Valprocic Acid (1000mg) and Primidone daily … I often said I feel like a walking pharmacy, but they are working. As with anyone with action myoclonus … I've been back and forth to hell many times, but feel I'm getting better every week and am on an active personal physical/speech regiment. I want my old life back ... I currently work hard each week toward gaining greater control and independence in my life! I found the stroke/aquatic classes (despite lack of weight bearing) at the local YMCA to be more helpful than past PT classes. I also found a very good movement disorder specialist in Sacramento, Ca. that has been very helpful. Don't get too discouraged
...we will get better!

Take care Brett Green”

Friday 17th August – Day 172 – sadly O was readmitted to hospital this evening, seems to be 2 steps forward and then one back. He has needed a lot of oxygen and has not been sleeping well, even with all the medication. The epileptic fits returned late this afternoon and seemed necessary to take him to emergency where the doctors decided he needs to stay in hospital for a few days. Though he looks totally incapacitated with little control over what is going on, his brain is working and responding, it’s the rest of him that is not. For example he can use a TV remote and select the channel he is asked to – may seem simple but for some fit and healthy people that can be a problem!! We are hoping they may try some new medication called Keppra (mentioned in the letter above by Brett Green) O is already on Valprocic Acid which has been a lifesaver. We are all hoping for more improvements when he gets out, he is a fighter and deserves to get as well as possible. Even in his handicapped state he can always raise a smile and try to make a joke.

Tuesday 28th August – Day 183 – and today is O’s 33rd Birthday, we are all grateful to have him still with us, and will have a little Party in his honour this evening. There has been real progress since his last admission to hospital, he was kept in for 8 nights, and released on Saturday morning. The medication is now controlling the epileptic fits more successfully and mentally he is the brightest he has been. He is trying to get to grips with using a Zimmer Frame, understands in principle but cannot do it without being supported, also he is trying to move too quickly (run before he can walk!!) but that is a good sign shows his will is there. He has a healthy appetite and needs to put a lot of muscle back on. There is a long way to go but I reckon that if after the first week of his illness we were given a look into the future we would have been overjoyed to see O make it this far. Little tell tale signs show us that his brain is pretty much intact, for example yesterday he had a headache (bort hoor in Thai), and managed to say the word headache in English as he was talking to me, the fact that he recognizes me as non Thai, and remembers English words at all is a very good sign. His speech is very slurred and hard to understand at times but he is always trying to talk and communicate which is great. So as he enters his 33rd year he has a long way to go – but I think we can all look forward with optimism and expect that in another 6 months time he will be walking, talking and enjoying a much better quality of life

Friday 7th September – Day 193 - We had to rush O back into hospital last Saturday morning, he was choking on his food, and became unconscious. It looked like he was gone for sure this time, he was pretty lifeless when we got him in the minibus, but he was back home the same day though will be using a feed tube for a while. It’s such a shame the spasms with his epilepsy can cause him to choke, he is much more with us than before but the uncontrollable shaking must be awful for him; at least he now understands why he needs the feed tube and doesn’t pull it out. Saturday morning we really thought we had lost O, but in the evening he was actually wheeling himself around the living room, unfortunately even trying to wheel down the steps!! Sunday morning he was on the exercise bike, a brilliant idea its perfect for him to build up his leg muscles. He looks a bit sorry for himself at the moment, he must hate having the food tube back in, but he becoming better by the day, mentally at least. Seeing him peddling away on the exercise bike shows real progress. He has continued improving awareness all week it’s only the spasms and lack of muscle that are preventing him healing quicker. Today he had a check-up at the hospital; I think they are quite amazed at his progress; maybe some had written him off. He is now not due to go back for another check up for a month. This week has seen amazing forward steps; O is coming back to the real world, his personality is showing through, he understands nearly everything around him, can read, can speak a little. At this rate one month’s time should show serious differences in his condition

Friday 28th September – Day 214 – It has been a while since the last UPDATE co_uk_cocogolf_db.as I have been away from home. O is still making good but slow progress; he can virtually walk unassisted with the use of a Zimmer frame. The epileptic fits are becoming under control and he is yet again more aware of his surroundings, speaking a lot more – but quite hard to understand. He is still fitted with a feeding tube, we hope he will get the all clear to have that removed at his next hospital check-up which is in around one week. The tube must be very frustrating for him as he has a good appetite and shows an interest in any food that appears, but he has to make do with his liquid meal. However he understands that he needs to keep the feeding tube in for safety, to make sure his medication is applied efficiently and to avoid the risk of choking. He is being well looked after at home, and is getting exercise to gradually build his muscles back up. The main thing is that for the past 3 weeks he is really back with us, part of the household and the days of any sort of PVS are now history. I believe he has beaten huge odds to reach this point, after doing a bit of research on the internet. Very few people make a recovery at all after the length of time he was in a coma.

Sunday 21st October – Day 238 – It has been a while since the last update, the season has begun and I have had to be in Pattaya the past two weeks. O’s progress is very slow regarding his muscles rebuilding. Sadly the hospital have decided that he needs to keep the feeding tube a few weeks more, I am sure as he is without that things might speed up. O has a good appetite and must be very frustrated always being fed liquid through a tube. He seems stable other wise, had regular sleep patterns and is comfortable. He is receiving regular physiotherapy and exercise though he does tire easily, and lose interest quickly. He has plenty of company and our next project is to try and teach him how to use a computer, he couldn’t use one before he was taken ill so it will be a bit of a challenge. All his children can use then (mainly for games!!) so hopefully they can help create an interest for him. He could play an acoustic guitar quite well before his illness, maybe when his epilepsy has gone completely he will begin to play again, I would think its good therapy for him. Thanks for all your nice e-mails regarding O, he is aware that many people are thinking about him, he always is happy to receive a visitor with a friendly face and is looking forward to meeting any regulars on the BEJUMO or Golden Triangle Tours in 2008

Wednesday 21st November – Day 269 – we are now in the busy season with many golfers here, so it is difficult to UPDATE co_uk_cocogolf_db.O’s story as often as we would like. Things with him are pretty stable at the moment but progress towards getting him back walking are slow. He still frequently has asthma attacks and often has a fever so the days where he is well enough to do significant exercise are limited. One problem with his exercise and physio is his concentration, his mind wanders and he forgets what he was doing. Our target has to be to get him as self dependant as possible within 12 months so we have 3 months to go. Thanks for the many e-mails and kind words from well wishers

Saturday 22nd December – Day 300 – and rather a milestone to reach. There is still progress but it is very slow. O now is off oxygen (unless an emergency) and has just started feeding himself (the eating part not the cooking – he used to be an excellent cook). He is on a healthy diet of Tuna & Broccoli, two of the best muscle building foods that are nice to eat. The two main problems he has now are muscle control and muscle building, he has severe muscle atrophy and there are hardly any signs that we have any improvement since the coma. He has a strong appetite, in fact that’s most of his conversation, telling us that he is hungry. We have to control his diet in line with his medication so he gets meals at set times 4 times a day. He has physiotherapy every day but he has little strength to do the exercises that he needs he rebuild his muscles, he gets taken out late afternoon for a trip around the estate, which he seems to enjoy. He sometimes walks part of the way (with assistance) but normally is in his wheelchair, he still cannot stand up unassisted. He spends about half the day sat up watching TV until he gets tired when he then lays down. A big target for us is to help him to regain some kind of continence as you can imagine this is getting rather monotonous for his main carers, and also for him, hopefully this will be his first step back to dignity. Though this UPDATE co_uk_cocogolf_db.may appear pessimistic, we have passed major points – he has a quality of life and he is out of immediate danger. We are all relieved to have him still with us and hope we can make it a good Xmas for him and his children

Saturday 20 January 2008 – Day 329 – and not that long to go before we are a year from his accident. Progress is still being made, though it’s very slow. The body spasms are still a problem and we needed to call an ambulance yesterday as they seemed particularly bad. However he was released after a few hours and all seems OK now. I believe we are near the breakthrough where he will be able to stand up by himself; he is getting frustrated in being totally immobile and is nearly strong enough now to move himself about. If it wasn’t for his shakes I think he would have made that stage already. Through all of this his asthma returns and slows things down progress wise, today he is having a bad asthma attack. However we are still moving forward so everyone is hoping for the best

Sunday 2 March 2008 – Day 372 – it’s been a long time since the last UPDATE co_uk_cocogolf_db.and there is not a lot to add. Progress is still happening buts it’s very slow. His medication keeps needing to be adjusted to control his shaking, he won’t be able to walk until the shaking is fully under control, but the will is there and he is trying hard. The muscles are improving and he is getting stronger. The asthma still gets him every week or so and that puts things on hold. He has a good appetite and is pleased to see people and was happy to meet some of our return guests that remember him from better days, he remembers people well it’s good to see his mind is still intact. Most important he now wants to walk and asks to exercise, in the early days when he was still very ill he did as we was asked but got very tired and it did distress him at times. Hope to have some good news for the next update – and thank you for following his story

Thursday 10 April 2008 – Day 411 – progress over the past month has been very slow, though O has managed to put on weight the combination of his asthma and the body spasms caused by his condition hamper any improvements. He was re-admitted back into Lanna Hospital Intensive Care Unit 4 days ago due to a particularly bad asthma attack and the fact that the medication was not controlling his shaking as it was supposed to. After one night in ICU he has been kept in hospital for observation and we expect him to be released in the next few days. It is good for him to have the occasional stay in hospital as it gives his Doctor a chance to keep him under observation and fine tune the medication prescribed. He is kept company while he is in hospital; someone always stays in his room. Prior to him being readmitted he had almost managed to walk on his own, hopefully he will achieve that landmark soon after he is released.

Wednesday 11 June 2008 – Day 475 – the time seems to pass so quickly these days, I suddenly realize I have not updated O’s condition for two months. The last few weeks have been good, a definite improvement in his speech and mobility and he has been spending a lot more time out of his bed. He has been even able to do some menial tasks to help from his wheelchair, like sanding furniture that we are renovating. The last two weeks have seen more improvement than in months in his general condition. He has a change of main carer which may be helping, but I think the contact company of his children when they are not at school helps the most. He has as sense of humour and can smile and laugh which is heartwarming to see. O always had a very infectious smile and it’s wonderful that he has not lost that. He is conscious of his appearance and has decided that he wants to grow a moustache and beard, touching when you realize its maybe the only decision he has the option on. The children are all doing reasonable well, though Ott his 10 year old son has severe asthma like his father, but he fights it and hardly misses a day’s school. Ell the 8 years old daughter has very high grades and should make it to university (which would be a first in their family), Omm the youngest daughter is only 6 and rather young to notice any academic skills. Jean O’s oldest son will be 13 on July 31st and we are quite proud of him as he plays the clarinet in his schools orchestra. Nice to be able to write a cheerful update – and thanks to all of you that take the time to read it

Monday 04 August 2008 – Day 524 – nothing much has happened during the last 7 weeks, we have moved home to a smaller place quite nearby, and O has moved with us, it’s more practical to take care of him and hope it’s a move for the best. He has put on muscles and is not far short of his original weight, but unfortunately the control for those muscles has not developed and he is still unable to walk and is incontinent. Some days he is in good spirits and is trying to do more and more for himself but the regular return of his asthma attacks hampers any real progress. We have planned that his wife can stop work soon and take care for him full time, which may be the way forward. O will be 34 on August 28th, we hope he can make a few steps on that day.

Monday 22 September 2008 – Day 573 – it’s been a while since the last update, and I am pleased to say that there has been noticeable improvement over the past few weeks. Five weeks ago we took the step of contacting a nursing agency to find somebody to look after O during our main season, as it was difficult to be sure that someone could always be within distance, and he needs 24 hour care. So on 15 August Sila started taking care of O; 6 days a week 07:00 to 19:00. Sila had recently qualified from nursing school and has proved to be a real gem, taking a lot of pressure of the rest of us and more to the point enabling improvements in O’s condition and quality of life. He is now capable of walking round a room as long as he has rail to cling to, and Sila is using massage techniques to try to bring life back to his atrophied muscles. His general being is the best ever since his illness, Sila is excellent with his medication and I think we can see a time in the future when he can walk and look after himself a bit more. Its been a long route to get to this point, and many times we have had to rush O back to hospital – I think his life has been saved on half a dozen occasions at least, but now we feel he is out of danger and he is progressing well. Our target now is walking by Xmas, only 3 months away!! It would be a wonderful present for his 11 year old son who will be 12 on Xmas Day.

Sunday 04 January 2009 – Day 676 – O’s progress has been steady over the past few months, though we have not managed to get him to walk yet, maybe we are expecting too much. Some days he is quite alert and we take him out in his wheelchair, but other days he seems to want to stay in his room. He is very vulnerable to colds and minor infections. He managed to go out for a birthday party on December 30th and was in good spirits, all of his children were there and it was a good evening. Sadly on New Year’s Eve he suffered a relapse and has been re-admitted to hospital, and he has now been there for 4 nights, it made us all rather sober on that special night – and realise how committed you need to be to care for someone so seriously handicapped. He is now out of danger and should be home in a couple of days. Only 54 days and it will be two years since his accident. A new year’s wish for all who read O’s story – may 2009 be a healthy and prosperous year, and all news be good news.... but most of all thank you for caring.

Thursday 23 July 2009 – Day 876 – where does the time go?  Unfortunately after all this time we have no good news about O.  He has made little progress in the last 7 months, his sister Mam has moved up from Bangkok with her children to take care of him and he is happy to have her around.  We are being very careful about exposing him to the current swine flu virus as he would struggle to survive it in his condition.  Only one month before his 35^th birthday, let’s hope we get some luck.

Saturday 05 December 2009 – Day 1013 – more than 1,000 days has passed and it is not too long before it will be 3 years since O suffered his heart attack and subsequent coma.  Back in August we admitted O to the McKean Institute Rehabilitation centre in Chiangmai, a wonderful establishment first established by Christian Missionary James W McKean back in 1908.  Follow this link for full details http://www.cpamedia.com/research/mckean/   Though O’s medical condition is stable he is still plagued by asthma attacks and is unable to walk, talk properly or take care of himself.  At McKean he gets physiotherapy and occupational therapy and is slowly regaining strength and we hope that one day he will be able to do a lot more for himself.  There is a visible improvement in his appearance since he has been there, and we bring him home at weekends when practical, he looks forward to his home visits but it has been difficult to arrange to pick him up every weekend since the last two months have been very busy.  The staff at the McKean are wonderful caring people and the premises are kept spotlessly clean.  The McKean rehabilitation centre is in a large block of land to the south of Chiangmai City around 25 kilometres from home, located next to the River Ping.  Our staff and customers that have visited McKean have been most impressed and we have decided that the McKean Institute will be our nominated charity for any events or fund raising.  There also is a new project recently opened on the land adjacent to the rehabilitation wing, aimed at catering for the urgent need for care for the elderly and those suffering with age related illnesses such as Alzheimer's.  Full details will be posted shortly and we hope to raise funds for this admirable project in the future.

Tuesday 2 March 2010 – Day 1097 – Now over 3 years since his heart attack and subsequent coma, sadly on the 26th Feb exactly 3 years on he was admitted back into the ICU unit of a nearby hospital. He is still in ICU with a lung infection which we are hoping does not develop into pneumonia. The staff at McKean have tried their best but he has made little progress and I think if he makes it out of ICU this time we will bring him home. Sadly he is weakening and physically his condition has regressed.

Sunday 15 August 2010 – Day 1262 – O has been in and out of hospital over the past few months, he is still in good spirits so his attitude to life has to be admired, and though his quality of life is so low he still wants to be with us and on good days has a hearty appetite and a big smile, even though he cannot walk, talk properly or look after himself. His Father passed away in July and he was well enough to make the journey from Chiang Mai to Bangkok, though of course it was a sad event; it gave O a chance to see cousins and relatives he had not seen for several years, and also spend the night in the house he had been brought up in. Very emotional times and a few tears were shed. O no longer stays at McKean it became too expensive and also we feel he has now reached a point that he will not improve upon, he is happier being at home with us being looked after by his sister Mam and family. Earlier on in June we took O and the whole family out to Mae Sa Waterfall and Wieng Khum Kam for the day, group photo is below:

Saturday 7th May 2011 – Day 1522 – it has been a long while since the last update on O’s condition.  His condition had not really changed much and unfortunately earlier this year he had to be admitted back into intensive care several times.  Two weeks ago his sister decided to move back to Bangkok and I decided to move O into my house where we are the process of converting an area into a specially equipped room for him.  His children are all now living with him in the house and as they are getting older they are now helping take care of him.  Their mother who has been separated from him for several years is also proving to be a great help and her time with him is most appreciated.  He is now living in a much improved environment and the change has definitely been for the best.  He is much more active and with his medication under much better control there has been noticeable progress, he has a much more active day and gets taken out a lot more.  He has managed to begin to use a walking frame though does need someone behind him to stop him falling backwards.  His movements are very jerky which does affect his balance.  He is in good spirits and is always pleased to see visitors, he hasn’t lost his memory and can still remember everybody from his past, even if he had only seen them a few times.  It was moving to see him using a laptop to speak with his cousins and aunts and uncles in Bangkok via SKYPE with camera.  His speech is still greatly impaired but with patience he can be understood.  So the news is good at the moment and maybe he will gain some independence during 2011 he will be 37 on August 28th