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Andrew Cruz Cajita
written by his mother Stella
April - May 2009
On my last update in March, I mentioned that two medications - Insulin for Diabetes and Clonodine for the Heart were discontinued. During the month of April, the doctor finally discontinued Andrew’s blood pressure medication too. The nurses were withholding the Inderal most of the time because Andrew’s brain is also regulating his blood pressure at normal levels. Andrew has gained weight at A Grace Sub-acute. He looks healthy. He now gets physical therapy once a day, 4 to 5 days a week. The Family takes up the slack from the decreased amount of PT and OT by doing some the “Range of Motion,” and other exercises. (Please note that PT, OT & ST were each 3x per day, 5 days a week at Kentfield Rehabilitation Hospital.) In addition, family is in-charge of placing the special Dyna-Splints for Andrew’s right elbow, left knee and feet to control the “foot drops.” Andrew’s spasticity/toning have lessened significantly in the last two months. Andrew still gets the RMNS treatment. (Right Median Nerve Stimulation) He is also more alert these days. When he wants to, he turns his head to see who walks into the room. When speaking to him, he would also turn his head towards your face and he will lock eyes with you when you get his focused attention! Andrew’s VP Shunt has been adjusted several times since January. The last adjustment was May 13th. We are getting closer to the most “optimum” setting on the basis of the CT Scans. We are blessed to have such a wonderful Neuro-Trauma surgeon (Dr. Paul Larson) at UCSF Medical Center in San Francisco. Andrew’s visit to the Neurologist is about every 6 weeks. It is almost an all day affair; we leave A Grace Sub-acute in San Jose via ambulance with both an EMT and Paramedic staff to San Francisco. The CT scan is done about 1-2 hours before his appointment with Dr. Larson. Dr. Larson has some awesome staff who works diligently and creatively to schedule both appointments on the same day to minimize the ambulance trips to San Francisco. I am so grateful to Dr. Deborah Doherty of Kentfield Rehabilitation Hospital. She and her dedicated staff worked very hard in getting us into the UCSF Medical Center before our transfer out of Kentfield Hospital. Dr. Doherty got us into UCSF for a VP Shunt Study in January to reveal that the Codman Hakim Shunt was in fact, for sure, 100% operational. Then a series on CT studies and adjustments followed for VP Shunt Optimizations.
We are always on top of Andrew’s medical treatments, and coupled with our deep Faith in the LORD, we are confident of Andrew’s recovery. This tragic event has brought us so much closer to GOD and I know HE will turn this event into something of HIS own Purpose. Andrew’s full recovery is already CLAIMED! I am so fortunate to have met some wonderful people from Harvest International Christian Church in San Jose, California. http://www.harvesticc.org/tp40/Default.asp?ID=110261
I remember I fought so hard not to come here to San Jose when the insurance companies were booting us out of Kentfield Hospital of Marin County. But you know what - I truly believe GOD works in “mysterious ways.” He brought us here to San Jose and placed us in the path of so many loving and supporting people from the church. I would have become despondent and in complete despair if it wasn’t for their loving and caring support. I have learned so much from the church of about Faith, Hope, and most of all - Forgiveness and Healing.
My dear friend, Sister Selena Villamaria and companions from the church often come to the hospital to pray for Andrew. I even met the renowned Evangelist; Pastor Peter Kumar who travels the World also visited the hospital to pray for my son.
http://endtimeforerunners.org/aboutus_peter.htm
Furthermore, we also met a wonderful Bishop from the Philippines, Bishop Andy Gaor and his wife who also prayed for our beloved Andrew. I’ve been blessed to have met so many kind and caring people during this time of my life here in San Jose, California.
I have added Bible Readings to Andrew’s Stimulation Therapy. Andrew’s perception is there and I can see it - he listens, he gets bright eyes as he perks up while I read the stories of some of the Gospels. It stimulates his mind; I make the readings sound interesting and at times suspenseful. This is how I know that Andrew comprehends his surroundings and he is getting better each and every day.
GOD BLESSES YOU ALL – Andrew’s Mom.
p.s. the pictures were taken on May 18, 2009
I do not even know where to begin. There has been so much pain and suffering since my son’s accident. I never knew a human being is even capable of feeling so much pain and shedding so many tears.
It was a parent’s worst nightmare. The telephone rang about 5:30 in the morning on May 4, 2008. It was my father. He said a hospital in Oregon has been trying to call our home. Andrew has been involved in a tragic automobile accident. The word, “tragic” sent indescribable chills through my body. We needed to fly to Portland, Oregon ASAP!
I was so tired from working that night that I slept through the telephone ringing. I immediately called the hospital telephone number obtained from my father. They would not give me specific details; only that my son is going to be Life-flighted from Mercy Hospital in Roseburg, to Legacy Emanuel Hospital in Portland. They told me to hurry because they did not think he would live due to the severity of the injury.
I got on the first available flight to Portland Oregon. I left so fast that I was just wearing pajamas under my coat. It was the worst feeling I’ve ever felt in my entire life! I did not know when I arrived in Oregon if I was going to identify Andrew’s body, or would he still be alive? It felt like eternity to get to my destination.
When I finally arrived at Legacy Emanuel Hospital, I was brief by the ICU Administrator of my son’s current conditions. He sustained severe brain injuries. He has lacerated liver, bruised lungs, four broken ribs, a right leg that was broken in several places and a slew of cuts in varying sizes all over his face, arms and body. They told me that he may or may not make it in the next 72 hours.
Andrew immediately had brain surgery upon arrival to Legacy Emanuel Hospital to stop the acute subdural hemorrhage and herniation. They performed decompressive craniotomy to control the ICP (Inter Cranial Pressure). They cut out the left side of his skull (bone flap) to help relieve the pressure as the brain continued to swell. The Neuro-Trauma Surgeon told me that prognosis is very poor. Andrew’s GCS (Glasgow Coma Scale) score on admission was a 3, which is the lowest score on the scale. There also has been a great deal of mass effect and brain shift and it has been some time since the accident. Andrew’s brain injuries were nebulous.
Andrew was placed on a ventilator since he could not breathe on his own. His body temperature was brought down (forced hypothermia) to help preserve the brain. There was also an external drain on his head that monitored the ICP and forced out excessive cerebral spinal fluid to help regulate the pressure. He was in ICU for a long time.
In summary, Andrew underwent many brain surgeries. He’s had numerous Burr Holes, http://www.neurosurgerypa.com/procedures/Burrhole.html
Multiple Ventriculostomy due to complication from Bacterial Meningitis Infection, http://www.upstate.edu/uhpated/pdf/ventriculostomy.pdf
The replacement of the Bone Flap,
http://www.mayfieldclinic.com/PE-Craniotomy.htm
And finally the VP Shunt.
http://www.jeffersonhospital.org/rx_files/neurosurgery/venshunt9943.pdf
He will forever live with a VP Shunt because the brain has shrunk due to Brain Atrophy. Through the course of six months at the hospital, he has battled many infections and worst of all – The severe Dysautonomic Syndrome. http://www.acnr.co.uk/mar_apr_2008/ACNRMA08_current.pdf
At one point, the syndrome episodes were so severe, that the doctors thought Andrew was going to go to cardiac arrest. They immediately gave him heart medication in addition to the 10 different medications that kept him stable. Andrew’s Cerebral Cortex is disconnected from the Brainstem and has Diffuse Axonal Injury.
The accident happened southbound on Highway I-5 in the city of Roseburg, Oregon which is one hour from the California border in the early morning of Sunday, May 4, 2008. I was informed by Andrew’s best friend that he dropped off Andrew at the San Francisco International Airport on the morning of Saturday, May 3rd. Andrew told his friend that he was going to fly to Sea-Tac International Airport. His plans were to pick up his girlfriend Chanthea, at Fort Lewis Army Base in Washington and drive her to her family in Fresno, California.
Chanthea, an Army Soldier was 8 months pregnant. Her nickname was Tia to those close to her such as family, friends and Andrew . Due to later part of her pregnancy, Tia was told by the airlines that they cannot accept her as an airline passenger. My son Andrew, being such a loyal person took it upon himself to bring Tia home to her family. She wanted to be surrounded by Family when the baby was born.
On the basis of witness statements, the State Trooper concluded that the drunk driver drove 5 miles erratically and not a single person called 911. She ran people off the road within the city limits. There were also people who stated they saw her from a distance and pulled over to let her pass. Then she found a freeway exit and got on the freeway exit thinking it was a freeway entrance. She was driving on the wrong side of the freeway! She drove the left lane, thinking it was the right lane. She flashed on coming traffic with her high bean head lights thinking they were all going the wrong way. Then a driver heading Northbound towards Washington saw her driving the same direction as he were, but realized she was on the other side of the concrete divider! The northbound driver was shocked, so he honked profusely at the drunk driver. This prompted the drunk driver to speed up the hill and then within moments, the dark sky lit up like a bomb exploded. Unfortunately for Andrew and Tia, they were just coming around a windy part of I-5 and did not have enough time to see the drunk driver. Reports indicated Andrew was driving at 65 MPH. The drunk driver was estimated to have been driving around 80-90 MPH. Tia, the Baby, and the drunk driver died instantly. Andrew’s car spun around until it hit the concrete divider at such great forces that the car literally moved and misaligned the concrete divider that separated the north and south bound lanes. There were baby things and body parts all over the freeway. I-5 was closed for 4 hours. To this day, I cry when I think the accident could have been prevented if only people cared enough to have called 911.
http://www.google.com/search?hl=en&q=andrew+cruz+cajita&btnG=Search
The supplemental police report indicated that the drunk driver, 40 year old Cheryl Rowe, left her residence in Albany, Oregon on Friday. She was going to have a weekend visit with her two children who lived with their father in Roseburg, Oregon. On the night of the accident, it was reported that Cheryl Rowe was at her older son’s girlfriend’s apartment. There were also reports of other witnesses who stated seeing her drinking alcohol during the day on Saturday. By evening, she was very intoxicated.
Something had happened in the apartment that made Cheryl Rowe very agitated, prompted her to take the car keys and drive off. The son indicated that he went after her because he knew she was very drunk. He said he came back to the apartment because he could no longer find her – but his greatest mistake was he didn't even bother calling 911 to summon help from the police.
Tia had just purchased a brand new 2008 Hyundai Electra. The dealership provided 30-day insurance coverage as routine so it could be driven off the lot. Unfortunately, Tia forgot to continue the insurance coverage on the brand new car. The insurance had just expired by two days. My son never knew the car he was driving an uninsured vehicle.
It has been 6 months since the accident. My son was in a deep Coma, but emerged to a Persistent Vegetative State. Doctors at Legacy Emanuel Hospital could not tell us about future recovery. They said he may never wake up due to the extent of brain injury. Some doctors even said, “This maybe as good as it gets.” The family would just have to take it one day at the time. I beg GOD for Mercy to heal Andrew’s severely injured brain. The words of the doctors are very, very painful, but it was explained that they were only doing their job to prepare families for the worst. Any recovery we get will be a “Bonus.”
My son has been transferred to Kentfield Long Term Acute Care Hospital in Kentfield California. I don’t know how long we are going to be here, or even know where we are going in the future. He still suffers from the Dysautonomic Syndrome, and is always fighting infections. I spend almost all my time by my son’s bedside. I talk to him, sing, pray, read, play music, caress and massage him - anything that will help wake him up. I pray for a miracle everyday and I ask everybody to do the same for Andrew’s sake.
My heart has been torn into millions of pieces. I hope that someday happiness will come again.
Stella Cruz, Andrew’s Mom
Friday: January 9, 2009
Update – We have been at Kentfield for almost 3 months now and the time has come for us to leave. How sad. The insurance companies said they already over extended our stay at Kentfield Long Term Acute Care Hospital and Rehab. Andrew didn't wake up from the PVS, Persisted Vegetative State. The insurance company wants to send Andrew to the next level of care – to a lower level Sub-acute Care.
There are only a few Sub-acute Care facilities in a favorable location. There is one in San Francisco, St. Lukes Hospital who declined to take Andrew because they do not take outside CPMC patients. I even went to St. Lukes on Christmas Eve Admitting Office. Two women met with me, I begged them to find out why St. Lukes Sub-acute unit denied care for Andrew, who was in fact born at that same hospital in July 1986. I had tears in my eyes and they consoled me. They Xerox copied Andrew’s Blue Cross and Cigna Cards. The even took the Medi-Cal coverage information, and then both women walked me out of the hospital promising to call back. When they did call, it was with great regrets, but according to headquarters, CPMC who now owns St. Lukes, do not take outside patients. How Merry Christmas could be with such devastating news.
The next two facilities are in San Jose, but they aren’t that favorable according to database complaint research. Our last hope is Seton Hospital Sub-acute. But for two weeks of feverishly working with Seton, they made us jump through hoops. It took 1 ½ weeks to clear Andrew through their Finance Dept. Then the heart break, the Medical Director declined to take Andrew because he was “high-maintenance.” Rumor flow in Kentfield from other Families – Seton will discriminate certain patients such as my son – who is a TBI patient. (Traumatic Brain Injury) After pre-qualifying patients, they weed them out one by one. First they said, they would take Andrew, and then they said, oh Andrew must first complete a Shunt Study at UCSF, so they would know that they will not encounter any Shunt problems during his stay. Then finally the test results of the Shunt Study came – there were no issues with the Shunts, it actually revealed there was room for more adjustments which maybe the reason why the ventricles are still so huge and the reason he has not waken from the Coma. But by now, Seton said “they were full, we have no more bed.” The emotional pain is just overwhelming. They favor certain types of patients – patients on Ventilators and Dialysis. They are more concerned about bottom line - Low Maintenance and High $$$ Returns. The beds are too precious to give to someone like Andrew.
We got no place to go, but Kentfield, as with any hospital cannot just kick out patients out on the street! We have no choice but go to a non-hospital sub-acute facility. The Insurance Company is very pushy. Kentfield will work with 2 San Jose, Subacute Facilities next week. One is Amberwood Gardens Sub-acute and the other is A Grace Sub-acute.
Kentfield is contracted by the State of California to provide medical treatments for prisoners of San Quentin State Prison, who are murderers, rapist, robbers, terrorist, all of the hard-core criminals. The State of CALIFORNIA pays 2 guards per prisoner at Kentfield. Round – the – clock. They get top of the line drugs, NOT generic drugs like Andrew gets, and then the stab in mom’s heart – THEY CAN STAY AS LONG AS THEY WANT! But the State of California is broke!!! If America continues to operate this way – then we the regular citizens are DOOMED. The good people don’t stand a chance. My son Andrew was a good boy. He was a full time college student at Cal State East Bay and was due to graduate this year – 2009. He was majoring in Mechanical Engineering, but decided to change his major a year and half year ago to Business Finance. He would have already graduated. He worked 5 hours every day after school. He didn’t get much sleep; the only time he got caught up on his sleep is during the weekends. He is also loyal and compassionate to all his friends. He was a responsible kid, even elected to bring home his pregnant girlfriend back home to family to have a glorious birth. Andrew does not deserve this!!!
March 2009
Andrew was transferred at A Grace Sub-acute in San Jose California. There have been improvements in Andrew’s condition. His brain is now regulating his pancreas and no longer requires Insulin. The same goes for his Heart, the doctor discontinued the Clonodine. His Blood Pressure is also at normal levels 95% of the time, prompting the nurses to withhold the Inderal medication. The Dysautonomic Syndrome also has lessened in intensity. Most of the Spasticity drugs have been reduced significantly. The decrease of medication is a positive change for my son since most of these medications are heavily sedating. This should help with arousal. Andrew has already demonstrated wakefulness. On one occasion, Andrew turned his head from left to right, as there were two people talking to him on each side. You can also look at Andrew and he will blink his eyes twice really fast, or keep them closed in a longer duration than your normal blink to let you know he acknowledges you. In addition, there was this very cheerful and caring CNA taking care of Andrew. She was singing a song to him during reposition and when we looked up at Andrew, he looked like he was smiling! Everything about his face showed a smile, except he cannot move his lips, but you can see the smile in his eyes!
We still have no long-term plan for Andrew. The medical insurances will exhaust in August 2009. Mom and Dad will work with employers to see if they can still provide medical coverage for another year – until the Federal benefit of MediCare becomes effective. The State’s MediCal benefit does not cover much. The Insurance Companies offered to help with obtaining medical equipment with Andrew’s DME benefit (Durable Medical Equipment). But we would have to take Andrew home, or find a boarding care facility of which the Insurance will not pay for his stay. I wouldn’t be able to take care of Andrew by myself, there are only three of us at home and we all work more than a full-time job just to survive. However, it is still an option to take him out of the Sub-acute facility and get all of the DME before the Insurance expires in August. The positive changes in Andrew’s condition can only get better. Our Lord, Jesus Christ is working on healing Andrew. He is already healed, we just have to “keep claiming” it everyday. Just as it states in Matthew 6:7-8 – Jesus, you demonstrated by healing the sick that the Kingdom of Heaven is at hand. You taught us to pray. “Thy will be done on earth as it is in heaven.” Let your will for wholeness be done, now in my life.” We have to keep pulling heaven down to earth everyday for Andrew with our prayers.
Mom’s email address is scruz58083@aol.com
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