11th September 2014

Steven continues his long journey to recovery. He knows he will never be the same as before the accident, but that doesn't stop him or us from doing the best we can to get him close to his previous life. To that end, Steven has started and continued a fitness regime at a local gym which specializes in the treatment of similarly handicapped people. This has resulted in him developing his muscles, and he does eat more. He is beginning to "bulk up" and looks well. A recent visit to the UK for his cousin's wedding resulted in many people commenting on his overall improvement. On a separate visit to UK, we attended the Queen's Medical Centre at Nottingham University Hospital, for an evaluation by pelvis and hip experts. We went expecting them to say that Steven needed another operation to correct his walking action, and help remove the intense pain he suffers at all times. Having looked at Steven's scans and x-rays, the Doctors stated that the hip replacement operation, in their opinion, was first class, and should not be causing the problems that Steven is experiencing, so a new operation was unnecessary. Due to Steven's ungainly gait, and the poor control over his left leg and left foot, they likened it to a baby learning to walk. They firmly believe that Steven's problems including the pain, are caused by severe damage to the sciatic nerve, and that this may take a long time to repair itself. They came to this conclusion because Steven does actually have some control over his leg and foot, if he had no control at all, the nerve would probably be irrepairable. They are confident that, in time, he will regain more and better use of his leg and foot. We left the meeting in a good frame of mind, and were grateful for the input and advice. In the meantime blood samples have been taken to discount any infection or any absorbed metal from the new joint. We will know the result in a few days. The Doctors may recommend pain management, but we have gone down this route before without success, unless there are new ways of pain management other than acupuncture, hypnosis, and botox. Steven will continue with his gym work and exercises at home, encouraging muscle growth, strength, and fitness.

6th July 2014

Another small update in Steven’s recovery. After yet another visit to hospital to see another doctor regarding the recurring pain in his left elbow, he and we received yet another opinion about the reason for the problem, and for once, this opinion seems to be correct. He was advised that, after seeing scans, there were small pieces of calicification “floating” around the elbow. The recommendation was no an operation, but was to work the elbow through the pain, to remove the calcification. Steven informed his trainer at his gym, and they came up with an exercise programme. As a result of this, and despite initial intense pain, Steven is beginning to straighten his elbow, the feeling in his fingers is returning, and the pain is subsiding. The result of this is that with one less pain to worry about, his general health is improving, to the point that he is actually putting on a small amount of weight, and there is a definite improvement in muscle definition. Whilst at the hospital, Steven also saw a “plastic surgeon” with a view to repairing or improving the look of his tracheotomy scar. From there we visited another surgeon who gave him two options for the repair. One was to remove muscle from his chest and place this into his throat, the other was to extract fat from his body to put into the area of the scar, and then hide it with a skin graft. Steven decided on the second option since he didn’t want any more scars. However, he was told, that during the operation, if that didn’t work, they would have to go for the first option whilst on the operating table. In the meantime Steven has made another visit to the hospital for a session of laser hair removal around the throat area, which was far more painful than he expected. He has to go for another session of hair removal in about 3 weeks, and then a decision will be made about the date of his throat surgery.

7th June 2014

It’s been quite a while since my last update of Steven’s progress. The reasons for this are many, concerning us, his family, as well as Steven. Steven has made a remarkable recovery over the 3½ years, but he has reached a “plateau”. We and he still haven’t stopped fighting for his recovery and justice, but at the moment there has been very little change in the last few months. He continues to be mobile, he continues his treatments of massage and exercise, but he still suffers from all manner of pains to his left side, particularly his elbow, hip and pelvis. His stress or patience levels are improving, his emotional outbursts are diminishing. Steven has stopped going to Elche hospital for physiotherapy because the regime was becoming repetitive, and having learnt so much there, he can do the same exercises at home. He has continued his massage, heat therapy, and acupuncture. He has recently started at a local gym specialising in recuperative therapy following accident or illness. This is already showing slight improvement in muscle tone and general fitness. After a long delay in getting appointments, he again saw a Doctor about his elbow. After x-rays and consultation, it was decided that an operation was not necessary. According to the Doctor, Steven has to endure more pain by vigorously exercising the elbow to remove “floating” calcification. In time this should relieve his elbow pain, and restore feeling to the fingers of his left hand. Regarding his hip and pelvis, we have decided to obtain advice and help from England. We were able to send excellent scans of his pelvis and hip to an English hospital, where experts agree that the pelvis is now fully healed, but in the wrong manner. These Doctors are also loathe to re-break the pelvis to restore it to its original state. The Doctors believe that Steven is not getting pain from the actual pelvis, but from the muscles surrounding the hip and pelvis. But these Doctors also discovered that when Steven had a hip replacement, it seems that the hip joint was replaced without taking into consideration the displaced pelvis. Their opinion is to re-do the hip replacement, and twist his leg into the correct position with the damaged pelvis. This will then hopefully put all the bones and muscles into alignment. We visit England in September for personal consultation rather than the up to now informative e-mail exchanges. As well as Steven’s health and his constant visits for treatments, we have had a large number of other problems, none of which help our own stress levels. After much deliberation between our solicitor and the taxi insurance, we have reluctantly accepted an offer of compensation. However this compensation falls short of what we feel is fair. The compensation was ordered by the local Court according to Spanish Law. The alternative would have meant paying a solicitor about €15,000 up front, and a potential delay of up to 15years to get any further compensation, and even then, there was the possibility of still receiving the Court’s amount, from which we would then have to pay the insurance companies costs. This is David versus Goliath, and was an incredibly difficult decision to make, and one we didn’t reach lightly. Then there was a battle with the Spanish Social Security. After a vast number of Medical examinations, and reports from all sorts of Doctors, Steven was awarded a Spanish disability pension. Despite all the Doctors stating that Steven would never have the capacity to learn, and would never work again, the Social Security gave Steven a disability rating of 52% Total and Permanent Disability. Ten months before Steven’s accident, he was in full time contracted work, which meant he was able to legally obtain a Social Security pension. He bought his own house with our help. As normal when buying a house with a mortgage, he and we took out the usual mortgage protection insurance. So, armed with the Social Security report, we approached the Bank’s insurance company, with a view to claiming on the insurance for the mortgage to be paid. After several weeks the decision was given that Steven did not qualify for this payment, because it was only payable on Absolute and Permanent Disability. We returned to the Social Security to appeal their rating, and after yet more examinations they increased Steven’s rating to 55% Total and Permanent Disability, but would not give Absolute and Permanent Disability. We appealed to the mortgage insurance, but they were adamant that the rules said Absolute and Permanent Disability. This basically means that Steven would have to be virtually fully paralysed and totally helpless before any payment was made. To us, the insurance was worthless. Steven cannot work, that’s agreed by everyone, but he still has to pay his mortgage. Further, the insurance papers actually give the insurance company the right to come to their own decision despite any Doctors or Social Security reports. When the house was purchased, as is normal in Spain we paid all relevant taxes. However, whilst Steven was in hospital we received notification that we had underpaid €6000 in taxes, and they wanted their money, as if we hadn’t got enough problems. We went to our solicitor as soon as we were able, and appealed the alleged unpaid tax. In the meantime the tax authorities fined us €400 for not paying the disputed amount on time, something they shouldn’t have done whilst an appeal was in process. Unbelievably they then embargoed our bank accounts and removed the €6000, again in contravention of the appeal papers produced at Court. After another year, we won our appeal, successfully proving all taxes had been paid, and that the embargoed monies to be returned. Despite numerous letters and telephone calls this took a further 18months before our monies were finally returned. All the above battles with officialdom required many travels to offices, telephone calls, e-mails, letters, and all were and still are very debilitating. All these problems had to be dealt with at the same time as maintaining 2 houses, including normal life’s duties from shopping to cleaning. Steven is spending more time in his own house, but still needs help around his house from cleaning to making his bed. So, as you can see, we have been extremely busy in all manner of things, causing a lot of depression and anger, at a time when all we wanted was for Steven to get fitter and better.

5th February 2014

It’s been a while since an update, but the changes have been minimal. Over the last few months Steven has gained a little more stability in his walking. This was achieved by staff at his clinic making him walk, blindfolded, and carrying his walking stick in both hands out in front of him. The staff would then “knock” the walking stick, similar to being nudged in a crowded street. Steven has then had to regain his balance, not knowing where or when the next “knock” would come. This was frightening to begin with, but helpful. Steven has also been made to hold onto a bar with both hands and then jump with both feet. This was extremely difficult due to co-ordination of both legs, lack of control over his left foot on landing, and the pain, but he did jump about two inches. Though small, this is regarded as a small victory. This and other exercises learned at the physiotherapy clinic are replicated regularly at home. He has had another medicine change in the hope that it will minimise the pain, and he also has pain patches on his left leg and left foot, for about 12hrs overnight. This is helping, but the pain returns gradually over the next 12hrs. Steven’s general attitude is changing in that he now knows when he is stressed and angry, and takes steps to minimise this, or at least immediately apologize when he does/says things wrong. He is beginning to accept that anyone can make mistakes, and it’s not always caused by his brain damage. He does feel that he is returning slowly but surely to “normal”. He has continued with regular massage in the hope of returning muscle fibre to where it should be, and to compensate for the lack of general exercise. On the bureaucratic front, after many examinations by several doctors, including re-examinations by the same doctors, Steven has been given disability status by the Spanish Social Security, and is now in receipt of a small pension. We started this process in January 2011 at the suggestion of Social Security representative at Steven’s hospital, due to Steven’s poor prognosis. We are grateful for this, but cannot understand how and why this has taken so long to achieve, and cannot understand why the claim hasn’t been back-dated up to 3yrs. Every doctor’s report, and there have been many by different experts, shows that Steven will never be able to learn any trade due to the brain damage, and will never be able to work again due to mobility and pain issues. We understand the need for validation, but when it’s done by the same doctors checking their own findings, we find this most strange. Steven has had another brain scan which confirmed that the damage was still there. He has had one of his scan pictures printed and is now on display at home in a frame!! There have been many visits to the local Court in an attempt to gain compensation for his life change, and there will no doubt be many more. The scans, the x-rays, the doctor’s reports are all there to be seen by the taxi insurance company, it is now up to them to make an offer to Steven, although no amount will be sufficient, but we understand the realities of the financial world. As we have proved by badgering the Social Security, we will continue to fight for what we believe is right for Steven. We will not be brow-beaten, we have to ensure Steven’s future. Best regards Terry

7th November 2013

Steven has tried to live life as normal, as much as he can. He is learning about his abilities and limitations on an almost daily basis. He recently tried two things. One was a day out at a local nature/animal park, where he discovered that his walking abilities are somewhat limited due to the pathways being up and down hills, and around many bends. The path surface was good, but the changes in orientation were difficult, and with few seating areas. A tiring day but with good memories. He also tried a holiday away from home with a friend. This holiday was in a rural area. The problem here was the reverse of the day out trip. The surfaces were uneven and with many unseen obstructions amongst grass. His friend, though able in his own way, was unable to help Steven in the way that he relies on us for his walking and manoeuvring. This resulted in Steven not straying too far from his lodgings, but he found peace and tranquillity in his surroundings. We give Steven credit for at least trying to regain an active life, but it’s only in this way that he will learn and ultimately accept his limitations. Every day to him is a challenge. Yet another examination by Doctors, and following discussions with Doctors of various expertise, it has been confirmed that Steven’s pain is coming from the messages being sent and received by his damaged brain. During tests, he is having high sensitivity to pain in places such as neck, shoulder, ribs, left arm, pelvis, left leg etc, where there should be little or no pain, and no obvious reason for pain. The Doctors agree that his pelvis is misshapen, and that even if the pelvis was adjusted by removing small sections of bone to help “line up” the pelvis, this would not stop the pain. It may help his mobility but not remove the pain, because the pain is not coming from the pelvis. Pain-killing medicines by their very nature, cause drowsiness, so Steven is trying several different medicines at different strengths, to find something suitable for him. We will investigate the possibility of some sort of operation or “gadget” that could interrupt the signal from the brain, but as yet, not apparently possible or available. This aspect of Steven is so difficult to explain to people. To look at Steven, no-one would ever think that he had any problems, but the brain damage was extensive as previously described. Remember, the prognosis in the early days was not very good for Steven’s future. Unfortunately from our own experience, there are people who, if they cannot see disfigurement, or blood, or bone, are unable to accept that there are problems. Best regard Terry

1st November 2013

Once again there is little change in Steven’s condition. He continues with his treatments in Elche and massages in home town. He has been given a different regime of pills to help with his anxiety and pain levels. The pain from his hip is getting worse. What we, nor he knows is what is causing the pain. It could be the damaged section of brain, it could be the increased sensation of pain, it could be the extra exercise he is doing, or it could be his damaged pelvis. He has had new x-rays and an MRI scan in the hope that the cause of the pain could be found. We await the report. Steven has received a report from his Doctor in Murcia, which states that in his opinion Steven is 90% disabled. This report will be shown next week at the local Court, as part of Steven’s claim for damages. We have still not received any notification from the Social Security regarding his claim for benefits. Steven and us will continue to fight for his rights. Whatever needs doing, whatever steps are needed to enhance his recovery, we will do it, we will not give in to the big organisations. The scan and x-ray revealed no spinal abnormalities, but there was the possibility of excess calcium growth around the pelvis, and the hip replacement. We await a Doctor’s decision as to what to do about this. Steven’s attendance at Court was very emotional, since it seems that any damages paid would be according to Spanish law. It is doubtful whether the sums mentioned will be enough to ensure his future. The Court now has all relevant documentation regarding expenses paid for operations, medicines, Doctor’s reports, private Doctor appointments, x-rays and scans, living expenses, and house modifications. On top of that will be monies for injuries sustained, scars, days in hospital, days in treatment centres. This isn’t a finite list, just a generalisation. Steven still awaits confirmation of his disability status, and whether or not he is entitled to a pension. Dealing with bureaucracy is hard work, and stressful to all of us. Today is the third anniversary of Steven’s accident. Halloween and today passed without incident, but with lots of painful memories. Best regards Terry

11th September 2013

The recovery continues, with continual visits to the clinic at Elche, where they are concentrating their efforts on his ability to walk, and to reconcile any problems he has with the functions of his brain. He has received Botox injections to his lower left leg, and to the sole of his left foot. This is to relax the tendons which have “forgotten” what to do. He has also had medical tape put on his left leg from his knee down to and under his left foot. The idea with this is to make the foot fall flat on the floor. These efforts will take time, but first results are promising. Steven has been given many “brain” exercises, such as Sudoku, and other logic problems. He also has to speak in English for at least an hour with the nurses, to improve his vocabulary. Having built up his weight last winter, over the summer he has lost half a kilo, and is now 65kilos. But the staff at Elche are happy with this. Steven continues to live his life as best he can. He is generally happy, and copes admirably with his disabilities. But what he cannot do is shake off the pain. He can try to be busy in the hopes of “forgetting” the pain, but it isn’t easy. He recently had an appointment to see a Doctor in the hope of getting some sort of benefits from the Social Security. This is getting to be difficult due to the precarious position of the Spanish economy. This report is what we wrote for the benefit of the Social Security team for evaluating Steven’s disability. Some of which may have been written before. He suffered catastrophic injuries which still affect him today. He had extensive in-operable brain injury which has affected him in so many ways, and he and we are still learning what extra problems he has. The most difficult part of Steven’s life is convincing people that he has serious problems with pain management. It is felt by Steven and us as his carers that people seem to think that because Steven looks so well, that everything is fine. It is not. Steven’s biggest problem is just that, he looks so well, but he has a multitude of problems. He does try to cope with his disabilities but it’s difficult. The brain damage was, and presumably still is, extensive, affecting every part of his life, from morning to night-time, and even when asleep. His life is almost intolerable. He has to concentrate on whatever he is doing. If he gets interrupted, he has to stop what he is doing, and re-plan his next move. This is most important. He cannot do two things at the same time, or as we say, he cannot multi-task. In other words his mind is in constant turmoil, having to think about everything he does and react accordingly. He cannot feel the whole of the left side of his body. He only feels pain, and very little control. The concentration pain diminishes his ability to do almost anything. This is foremost in his mind. He has to deal with the pain at the same time as he tries to control his body. For a simple example he cannot clap his hands together in time. He describes his left side as wooden, or not belonging to him. He cannot dance, despite practicing, because the left side will not react as quickly as the right side. He finds it very difficult to speak, both in formulation of words and sentences, but also in maintaining a continuous conversation. He has to think about what he wants to say before he can say it, even then he has to often pause during speech. He was able to translate from Spanish to English to Spanish very quickly, but now he cannot do it as fast. He cannot interact in a group of people all talking. He was able to translate Spanish or English music to English or Spanish words, in order to sing-a-long, but now he cannot. He cannot concentrate on any particular subject for a great length of time, he is also very forgetful. If circumstances do not meet his expectations, he gets distressed, angry, and depressed. He feels hungry but finds it difficult to actually eat food. He cannot control his body temperature particularly when it’s cold. Also his hormones are not correct, he sweats very easily when warm, meaning that he has to have several showers. Working in bars he was accustomed to loud noise, but now he finds background noise irritating. He especially gets very upset when he hears children crying or screaming. This is a reminder of the screams from children and adults at various hospitals. This does not mean he does not like children, he does. It is the crying he does not like. Due to these sights and sounds experienced at various hospitals he gets upset easily when seeing people in a similar position to him. Steven finds it difficult to sleep due to the constant pain throughout his body, just catching his toes on the bed sheets causes pain. He also has nightmares of the accident and what he has had to experience during his recovery. Waking in the morning is difficult and slow. Often when he wakes up, he realises that this is his new life, having dreamt that he was living an ordinary life, this is particularly distressing. During the early months of his recovery he was in a state of horror, unable to tell us of his pain, problems, or feelings, and even now he is reminded of the pain, inconvenience, and embarrassment of this every time he shuts his eyes. He has had one hip joint replaced, but the pelvis is permanently twisted. This causes pain and discomfort whether sitting, standing, or walking. He has had two operations on his left elbow, but that still causes him severe pain. He is suffering pain in his left ankle, and this is believed to be excess calcium growth, which will probably mean another operation. This is a new problem and is yet to be investigated. He is uncomfortable with the look of his tracheotomy scar and is considering “plastic surgery”. He has permanent muscle pain down mainly his left side from his neck downwards, probably due to lack of use whilst in a coma and subsequent long recovery in hospital. He still does not have full control over the use of his left foot, particularly his toes, because they regularly curl under his foot when walking. He used to experience severe pain every time he tried to put on his shoes. The pain now is at least manageable. He has terrible scars and muscle wastage on his left leg from the accident and the insertion of a metal pin in his lower leg. He is a very bad passenger in a car. There are many drivers who drive so badly, or leave it to the last minute to stop at junctions, or especially drivers who fail to stop at red traffic lights, creating almost a state of panic in Steven. He can walk, with the aid of a walking stick, but only in a straight line and with no obstructions such as people, street signs, animals, high wind, or rough surfaces. This is the most difficult part of Steven’s problems. He has to be constantly vigilant. When walking he has to tell each and every part of his body to move in the correct manner. He has to monitor the way he moves every part of his left side in particular before he puts his foot down. He is constantly aware of his surroundings, and has to plan each move ahead. Any deviation from this plan can cause problems such as stumbling. He cannot put his left foot flat on the floor, because he has little or no control over his foot. When walking he puts all his weight on the right side, because he cannot feel his left side. He cannot walk and talk at the same time. He has tried to walk without the aid of a walking stick, but this causes problems, because other people assume there is nothing wrong with him, and this sometimes results in people bumping into him or expecting him to move out of their way, causing him to lose balance. By having his walking stick, not only does it give him support where needed, it also shows people that he has a mobility problem. He stumbles almost every day, and falls over about once a week due to loss of balance. He drops things on a regular basis, breaking many items of crockery, or spilling food on the floor. He has had to endure a vast amount of dental treatment being required, due to accident damage, and neglect when he was in a coma and having a tracheotomy. Steven’s speech is affected due to problems with his bottom jaw, though not broken was no doubt dislocated or jaw muscles affected. He has a problem with his short-term memory, forgetting very recent events, sometimes relying on messages on his mobile ‘phone. The latest examination by a Neurologist revealed that due to the brain damage Steven has hyper-sensitivity, this means that all of his pain is exaggerated. A simple gentle touch of his skin can cause irritation and even pain. He has recently started a new regime of medicines plus Botox injections to his left foot. These will allow the foot muscles and tendons to be more flexible and hopefully help alleviate the pain. A later Psychiatrists report written for the Social Security stated that Steven will never have the capability to study, remember facts or details, and would never be able to work. All these facts are now in the hands of the Social Security. It would be nice to get a positive result, and bring a small amount of closure. Best regards Terry