Ava Walks and Walks and Walks...

AVA WALKS AND WALKS AND WALKS………..

Over the past few weeks Ava has made great strides….literally! After Thanksgiving break we noticed an increase in the amount of steps Ava was taking and she is now to the point where I can officially say AVA IS WALKING. Several people have seen her and asked why I never put an update on caring bridge. My response to this was that I needed to wait until she was walking without falling every other step. Once again, Ava has beaten the odds. While it is an amazing thing that she is walking we still don’t know how much she is able to see. We are also unsure as to how much damage was done that is contributing to her lack of balance and coordination. At times she will walk into objects and at other times it appears as if she is just aimlessly walking around and not really focusing on anything. She continues to receive physical therapy three times a week, occupational therapy four times a week, vision therapy once a week and speech therapy twice a week.

As promised I wanted to give everyone an update on Ava’s appointment with the Neurosurgeon. A few weeks ago I mentioned that Ava now has a sixth nerve palsy in her right eye which was diagnosed by her opthamologist. Usually this is caused from increased intracranial pressure in the brain. After much discussion, the Opthamologist and Neurosurgeon have decided that on December 14th Ava will be re-evaluated. If she still has the 6th nerve palsy she will need to have an intracranial pressure monitor placed in her head and receive monitoring in the ICU for one to two days. If the pressure is increased she will require a shunt. Something that she will have long term. She is also going in for an MRI of her spine. She has complaints of pain in her lower back and we need to rule out a few things. I am not a doctor so I don’t even want to attempt to explain all of this. I am asking all of you to please say an extra prayer for her this weekend. While she is a strong little girl she doesn’t deserve any of this.

With that said, I am asking that all of you PLEASE send a letter to District Attorney Susan Reed asking her that this case be prosecuted to the fullest extent of the law. Our first trial date is set for January 19th. I will follow up with details. It is an open trial so if you are able to come and show your support for Ava our family would truly appreciate it. The address for Susan Reed is: 300 Dolorosa, Suite 5072, San Antonio, Texas 78205. Please address the letter to the attention of District Attorney Susan Reed. Email is not sufficient, we need written letters. Thank you all in advance. I would hate to see this happen to another innocent child or family.
Until next time….stay safe!

Love,
Traci

Thanksgiving

THANKSGIVING
Thanksgiving, in my mind, is a time to reflect on what we have to be thankful for. Growing up my brother always said that Thanksgiving was/is his favorite holiday. His reasons valid- to have time to spend with those you care about, no concerns about gift giving or receiving, a time to reflect on what matters most in life. It wasn’t until this year that I really have gained an appreciation for his feelings.
This past April my life changed forever. There are many days that my heart aches but just as many days if not more that I hear myself say ‘Wow, I have so much to be thankful for’. I want to take this special time of year to say THANK YOU. To all of my family – for your heartfelt dedication over the past 7 months, for listening to me when I just needed to cry, for being my strength when I felt I had none. Please know that although I may not say it often enough I love you all very much and am wishing you all that Happiest of Thanksgivings.
To my dear friends, thank you for your unconditional love and support. I think of you all as my family. You have been my pillars of strength during one of the most difficult, if not most difficult time of my life. You have made my family your own and for that I am eternally grateful. I hope to be the same kind of friend to each and every one of you.
To the city of San Antonio and those people around the world who have been praying for our family, especially Ava….thank you. I really do believe that all of the prayers have allowed our family to find strength during such a horrific time.
To all of the staff at University Hospital, Christus Santa Rosa and Rehab Associates…..thank you for saving my little girls life. Without your expertise I am certain we would not be where we are today. You all have a special place in my heart.
To Ava’s special friend Rosie….thank you for the countless hours of play therapy/OT you have done with Ava. Thank you for helping to give Ava some sense of “normalcy” to her life. There is a reason she lights up when she sees you because she realizes what an amazing person you are.
To Lilianna, for your beautiful pictures that have helped capture every moment of Ava’s recovery. Thank you for sharing your amazing gift with our family.
To my husband and children……THANK YOU FOR BEING SURVIVORS! I love you all more than words can describe.
With the last part said, I wanted to give a quick update on Ava’s recovery. A few weeks ago Ava had to go in for another cat scan. Unfortunately we were told that she has a new bleed in her head. We have also learned that she has a 6th nerve palsy in her right eye. A few nights ago she went in for more testing…MRI/MRA/MRV. The good news is that the MRV and MRA appear normal. The MRI confirmed the new bleed and also showed a mass effect. This basically means there is some pressure/swelling on her brain that needs to be evaluated. Ava will see a neurosurgeon early next week. Please say an extra prayer that all goes well. I will keep you posted.
HAPPY THANKSGIVING!
May you take this time to reflect on what you are thankful for. Don’t let time pass you by!
Love,
Traci

All for Ava Party Pictures

Enjoy these beautiful slideshows of Ava, her family, friends and countless supporters at the All for Ava Party! It was an amazing day!

http://www.liliannastoryslideshow.com/avabirthdaygirl/

http://www.liliannastoryslideshow.com/ava%27sbirthdaycelebration/

Coming out of the fog

Over the past 5 1/2 months I have felt like I have been living my life in a fog. Saturday, October 17th,the fog lifted for the first time and the sun shined brightly. It was the first time in 5 ½ months that I have seen a constant smile on my children’s faces. Saturday was a celebration of the ongoing recovery of our entire family and we were so happy to have all of you to share this special day with. Ava received so many special gifts and cards and I wanted to take this time to thank everyone for their thoughtfulness.

There were several people that were instrumental in making Saturday a success. Please know that I love each and every one of you and I will never forget the efforts you all put into making this day so special. Thank you to all of our family members and friends (far and near) that were able to come to the party. For those of you that were unable to attend, thank you for your continued love and support. It is with ALL of your help that we are able to keep fighting. Believe me there are certainly days that are more difficult than others.

As I have mentioned in the past, we are in the process of forming a charitable organization for pediatric head trauma and disorders. We feel we have been so blessed with the support we have received throughout this entire process. By forming the organization we hope to be able to provide for others in the future. The name of the organization is “Ava’s Wish”. I will continue to keep you updated on the progress of the organization.

The San Antonio Rock-n-Roll marathon is just around the corner. It will be held November 15th. We have been forming an “All for Ava” team which is so exciting. I will be placing an order for shirts within the next few days. The shirts will be a dri-mesh material. I anticipate the cost to be between $20.00 - $25.00. They will be pink for the women and gray for the men. If you are interested in purchasing one, please send an email with your name, phone number and size to lopeztraci@yahoo.com. I look forward to seeing everyone at the raceJ

Lopez Journal

Even if you can’t make it to the All for Ava party on Saturday, October 17th, you can still be a part of this memorable day. We will be compiling a journal for the Lopez family, which will include all of your heartfelt notes, thoughts and prayers. For those of you who are out of town or unable to make it, please send your notes to Kerri Thompson @ kerrithompsonaz@hotmail.com with a subject: Lopez Journal. We will have a table set up at the party for guests to write in the journal, as well. This journal will provide strength and comfort to the Lopez family as they continue to heal and recover. Thanks for your continued love and support.

Happy Birthday My Sweet Miracle!

SEPTEMBER 28, 2009

Today is such a special day…..today is Ava’s 2nd birthday. After being told the late hours of April 23rd that there was a strong possibility that Ava would not make it I have to say that today is monumental. Birthdays come and go yet today I don’t want the celebration to end. I feel like Ava has been given a second chance at life and we as parents have been given a second chance to love this little girl with every inch of air we breathe. Today I don’t want to think about the negative that surrounds this situation. I want to focus on the lasting impression Ava has made on so many people’s lives. I want to focus on the fact that I have three beautiful children, an amazing husband and wonderful family and friends. I want to embrace today with everything I have because I can.

HAPPY BIRTHDAY MY SWEET MIRACLE!

Ava's progress and party details

With summer coming to an end and the start of another school year I thought I would give an update on the progress Ava has made. It has been a little over four months since the accident occurred. If anyone were to have told me that Ava would be functioning at the level she is today I would have never believed them. Ava continues to receive PT and OT 5 days a week. She had been receiving speech therapy at an outpatient facility but will soon start to receive speech therapy at home. Vision therapy will be starting this week. Over the past few weeks Ava has mastered crawling. She is also pulling herself to a standing position in her crib and often will try to stand if someone is there to hold her hands. While she is still not walking and will most likely not for quite some time her desire to do so remains strong. I see it on a daily basis thru her frustration, anger and tears. As a parent this breaks me apart. If there was some way that I could walk for her I would . I see a now 22 month old that doesn’t quite understand why it is that she can no longer walk and why she has difficulty seeing to do it. She is certainly not old enough to understand although I’m not sure that an older child would really understand the severity of what has happened either. All that we can do at this point is remain positive for Ava and believe that just as everything else has come back so to will be her ability to walk. Ava is now wearing an AFO which is a brace on her leg that helps with some of the overextension problems (causing accumulation of fluid around the knee) she is having . She has had improvement with her left sided weakness but it still remains as does her facial weakness. She continues to wear a patch on her left eye to help correct the vision in her right eye. We saw the opthamologist a week ago and she said that Ava’s vision continues to improve. We have been able to decrease the length she wears the patch from 4 hours a day to 3. The doctor also said that her right visual field continues to improve and that her left visual field (which had been completely out since the accident) is starting to show signs of improvement. People ask me every day if Ava will ever see like she did prior to April 23rd and I answer by saying that I don’t know and unfortunately we may not have the answer to this question for quite some time. It is obvious that she has a deficit but she continues to fight for her vision just as she has with every other part of her body. Did I mention how amazing I think she is?????Ava continues to use the kid walk on a daily basis. Jack and Isa have been instrumental in her “walking therapy.” They use ice cream as an incentive to get her to walk. They like it, she likes it, everyone is happy.

On a lighter note, Manny and I have decided to run in the San Antonio Rock and Roll marathon/ ½ marathon on November 15th. We are forming an “All for Ava” team if anyone is interested. We have already had several people tell us that they would love to join us. We plan to wear “All for Ava” shirts in her honor. We are also in the process of forming a charitable organization in her name and will send you the details as soon as they are available. Lastly, our family would like to thank you all for your continued prayers and support. We feel like you all have such an important place in our lives…..to help guide the recovery of our daughter. Words will never be able to describe how much that means to us. Thank you for your strength…..we could not be where we are today without each and every one of you.

Love,
Traci

Please join us in celebrating Ava’s recovery: October 17, 2009
Rogers Ranch/Crosstimber Community Center
3:00 p.m.- 7:00 p.m.
WEAR PINKJ
More details to come

Pictures to last a lifetime

Lilianna Story did an amazing job capturing the love between the Lopez children. Hope you enjoy this heartwarming slideshow. It is breathtaking! Ava, we're so happy to see that vibrant smile again. We love you!

www.liliannastoryslideshow.com/lopezchildren

Meal Calendar has been reopened

We have opened up the meal calendar until the end of August due to overwhelming requests. If you're interested in signing up, please use the following link and log on credentials:

www.carecalendar.org

Calendar ID: 15804
Security Code: 9927

Thanks for everyone's continued support!

Baby Steps for Ava

Update on Ava’s recovery…….

We wanted to again thank you all for your continued thoughts and prayers for our family, especially Ava. Ava remains in therapy 5 days a week. She is in physical therapy 5 days a week, occupational therapy 5 days a week, speech therapy twice a week and visual therapy. She seems to be making improvements on a daily basis. To us that see her every day they seem like baby steps but to those who see her maybe once a week it seems like she is making great strides. The bottom line is she continues to improve and that is the most important thing. Her speech is still slurred at times but her vocabulary is back to where it was pre-accident. We have to prompt her most of the time to say specific words but she does repeat them. She will say Mama, Dada, Jack, Isa, Grandma and Callie without any prompting which is music to our ears! She is starting to sit by herself for longer periods of time and is able to transition from lying to sitting pretty effectively. She is also starting to crawl….more of a military crawl but we’ll take that for now.

We finally received the kid walk last week. We had been using the demo at Christus Santa Rosa for the past several weeks. It is not always Ava’s favorite thing however it seems like the time she spends in the kid walk(her tolerance level) increases with each time she is placed in it. She is able to take small steps using the kid walk and I am certain that this will be instrumental in helping her to regain the skills necessary to begin walking again. Ava’s vision is still impaired and we aren’t certain to what degree. We do know that she has a left visual field cut and that she is able to see in her right visual field. Her doctor said that the amount that she is seeing in her right visual field is improving. The last time we visited the eye doctor she noticed that Ava’s right eye has the tendency to deviate to the outside. Most likely due to the fact that her vision is better in her left eye which causes her to ignore her right eye. We are currently patching her left eye up to 4 hours a day. The goal is to make the right eye work more and hopefully the vision can be restored. It is amazing how complicated vision is….sorry that I am not able to break it down like Fred does so beautifully.

Ava continues to fight the fight! She gets easily frustrated but to some degree I think this is what keeps her going. She wants to be running and playing with all the kids just as much as we all want it. Someday soon I am hopeful that she gets exactly what she wants! Until that day (and always) we will be here to love and support her! Thank you all for the kindness you have given to Ava and our family over the past three months. We are in a better place because of each and every one of you!

Love,
Traci

We will not forget

I was on-call this weekend at Brooke Army Medical Center covering the Radiology Department. A woman bicyclist had been brought in to the ER after being hit by a car. She was in her late 30’s… an athlete, you could say… good physical condition prior to being hit… but this was no minor “accident.” The severity of her injuries were such that she could have easily died before making it to the operating room to have her internal injuries repaired. I have thought of her often since seeing her lay helplessly in the CT scanner… alone.

Early the next morning (Sunday) I went down to the cafeteria to get something to eat. The cafeteria was essentially empty with the exception of a few lone hospital workers eating some breakfast. In one quick glance you could guess the total number in the dining area as less than 10, but there was a cluster sitting at one of the tables. A group of adults sitting at a table talking…eating breakfast… but not really eating. Clearly, they were civilians by their attire. Family members of someone who was now a patient at the hospital… I presumed. It was early in the morning, but this group had not just awakened. These were vigil watchers. While I do not know who they were there worrying about… praying for… crying for… I imagined that they were the family members of the bicyclist that I had seen come in the evening before. I imagined them receiving the call…”your loved one was just hit by a car… You need to get here immediately… They may not survive.”

Your heart sinks as you think of receiving the call. Your stomach feels empty and sick. “I wish that I could vomit… if it would only help with the void and helplessness that I now feel.” As I walked by them I was quickly reminded of the first hours/days/weeks that were spent in the hospital with the extended Lopez/Southerington family… Ava’s Army. I remember that pain very well.

This story is not too dissimilar from Ava. One person with the promise of a lifetime… doing the right things… taking care of themselves… and in a fraction of an instant… it all changes.

But this story reminds me of something else… as I walk by this family my mind plays a trick on me… it makes me feel like I am back at University Hospital that night… I am again peering through the back of an ambulance watching my friend tremble as he tries to breathe life into his daughter… I see Traci sitting on the curb with blood smeared across her leg and arm… my stomach feels weak for a moment at the thought of it. The psychology of it all is curious. Why are we this way? Is our mind trying to protect us by not letting us forget how these things felt? Is it trying to make sure that we steer clear of the “danger?” Perhaps.

Interesting… and I am a guy… a typical guy… not overly sensitive… analytical… “rational.” I am even somewhat removed from it all. It wasn’t even my child. I didn’t even witness the event. Yet, I am affected by it, nonetheless. My thoughts take me to others… women… who tend to be more compassionate and empathetic than us insensate men.

I think about Jennifer, who witnessed the Lopez family being run-down in their yard… I know that she has not forgotten how that felt.

I think about the Lopez/Southerington families… I know that they have not forgotten how they felt.

I think about Manny… I KNOW that he has NOT forgotten how he felt.

I think about Traci… I KNOW THAT SHE HAS NOT FORGOTTEN HOW SHE FELT…
Nor will she… anytime soon.

The “void/emptiness/sickness” that you feel in your gut when something like this happens is called a “visceral reaction.” Your mind makes your body feel it. Traci’s mom nearly falling as she saw her daughter for the first time following being hit, is a “visceral reaction.” I got sick once after eating at Chili’s restaurant when I was going through chemotherapy. I have not eaten there since and still feel a twinge of queasiness whenever I drive by it. I see soldiers everyday whom have been burned and busted by the atrocities of war. What psychological demons they must face in their sleep every night.

PTSD (Post-Traumatic Stress Disorder) is a term that we are all quite familiar with, but many do not know that it is a spectrum of disease… mild to severe. It is not limited to soldiers at war and can occur after any “stressful” event. Our bodies heal long before the brain forgets. We must remember that psychological wounds hurt too. They can be hard to see… and they can take very long to heal.

Similarly, the Lopez family continues to heal from physical wounds at an exceptional rate. It has been less than three months since Ava was nearly killed (23Apr09). Her physical recovery has been meteoric to this point, but the wound to the Lopez family from the psychological trauma was deep… and it will take much longer to heal.

There was an encounter a few days ago…

The message was an uncompassionate… “get over it.” (in summary).
For those who share such sentiment I want to remind them that no one is making you participate in any way. The people who are participating in this community event do so out of the goodness in their heart… and they will be repaid in kind in the future… maybe not by this group… maybe not in this life… but one day they will need help… and they will receive it from the goodness of others… because they have been recognized as “being good.”

When Ava, Isa, and Traci were “injured,” those of us who care about them committed ourselves to them for the duration of their healing…

“For the duration of their healing.” What does this mean? When the bandages come off my responsibility is done? No.

Healing comes in many forms… physical and psychological. They are our friends. We have committed ourselves to them. We have committed to support them until they are whole again… in every way.

While Ava’s physical condition has improved dramatically, she is not yet whole… and neither is the Lopez family. And even when Ava is walking and running again, the psychological wound will remain… and so will their friends.

Just as I would not enter the bicyclist’s hospital room tomorrow and tell her to “get over” her extensive physical wounds, we cannot expect psychological wounds to heal just because we think that they should have healed by now. They will heal when they heal… and not any sooner than that.

Do not be angry and petty that this family has received so much attention and support. Be happy that their remains such goodness in this difficult world. Extend yourself to those who need it… It will pay dividends later… in this life… or the next.

Ava, the party waits for you.
fw.

Sign of Hope

Over the past few months a transformation has been taking place……the transformation of our side yard where the accident happened on the evening of April 23rd. There have been several neighbors/ friends in the Rogers Ranch community as well as friends/neighbors outside the community that have demonstrated the true meaning of “Community Support”. While this is something we never expected we truly appreciate all the effort that has gone into this special project. Instead of looking at our side yard as a place where lives were changed, dreams shattered and innocence lost I am hopeful to be able to look at it as a sign of hope. Hope that Ava makes a full recovery, hope that our family can continue to heal and grow together as one unit and hope that there will be a positive message to come from this horrific incident. We are very fortunate to have the support that has been offered since April 23rd.
To all of Ava’s angel’s….thank you again for exceeding our expectations.

Love,
The Lopez Family

Ava is the victim!

This is an extremely powerful and must read letter from Traci...

I had a difficult time sleeping last night and I wanted to share the reason why. Someone recently told me that a neighbor of the person that hit Ava, Isa and I feels as if she (the woman who hit us) is the victim in all of this. I have thought about this statement over and over and just can’t seem to get it out of my mind. I’m not quite sure how to react to this statement except to invite this neighbor to my house and introduce him/her to Ava….the 18 month old innocent child that was plowed down by his/her extremely impaired neighbor. I would like to show him my child that is unable to walk, crawl, stand, sit for any length of time without getting agitated or let alone see to help facilitate all of the above. My daughter who prior to April 23rd was all smiles and now becomes extremely frustrated and angry multiple times throughout the day because she has had a major brain injury and can’t understand why she is unable to do the things I just listed above. I would like this family to spend just one day with my daughter going to therapy, going to doctor’s visits, feeding her and reminding Ava that she needs to chew and swallow when she eats her meals, holding her because she is scared to be left alone. Then at the end of the night I would like them to explain to my 6 year old son why it is okay for this to have happened? Why the person that hit us is the victim? I talked to my son Jack last night regarding the accident….one of several conversations we have had since the accident. I told him that Ava used the kid walk in therapy today and that she did really well. She was able to bounce a ball back and forth with me while putting pressure thru her legs. I said Jack, isn’t that great’? His response was “Mommy I want Ava to be able to bounce the ball with me without that walker thing, like she used to”. To the neighbors that feel as if the woman that hit us is the victim, I ask you to put yourself in our position. I also want to know if you truly believe it is appropriate to pass along the message to our children that it is okay to drive while impaired? Fortunately for you this is not your child. You are not living the hell that I am.

To all of Ava’s angels…..I hope you understand that this needed to be addressed. I thank each of you for YOUR continued prayers and support.

Touched from afar

Sunday I was at the Rogers Ranch community pool with the kids. I was tucked away under the shelter of the pavilion trying to hide myself from the searing solar rays that we have had lately. From the shade I was watching the kids and few other families that were at the pool that day. Traci, her mom (Karen) and the three kids (Jack, Isa, and Ava) were at the pool with her. They were in the shallow end, at the steps that enter the pool. They had been there for what seemed like a rather long time just cooling themselves in the water.

A woman that had also been at the pool with her daughters got up from her seat and went over to Traci to introduce herself and let Traci know that she and her family had been thinking of the Lopez family and praying for them all. She was very respectful and clearly did not want to intrude on their family time and tried to separate herself from the conversation rather quickly, so as to not offend Traci. But the conversation continued for a short while.

Just after their conversation she came over to me and introduced herself, “Hi, I am Kim.” After exchanging our introductions our conversation quickly changed to something that we had in common… Ava.

Kim and her family had not had the priviledge that I have had of seeing Ava’s recovery in a more personal light and from so near. It is almost something that you take for granted… being so close… seeing her so often… seeing the small gains that she makes… seeing and becoming accustomed to the physical deficits that remain. It is so easy to forget how many people continue to follow from afar. It is so easy to forget how many people are emotionally invested in Ava’s recovery but do not have the luxury of getting to spend time with her or them… either because they lack the finances or time to be able to travel here eventhough they feel emotionally close enough… or because they are here but do not feel emotionally close enough to the family to “intrude,” so they watch from afar.

Traci’s family, Manny’s family, Larry, the Millers, the Lawrences, the Meiers, and countless others are examples of the former case.

Kim is an example of the later case. Someone that is here locally and who’s family is emotionally invested in the story of Ava, but they lack the familiarity with the Lopez family to openly address them under nearly any circumstance. So the relationship stays as it is… distant… watching from afar.

Kim and I, and later Traci and I, discussed that herein lies the problem. The relationship stays distant because we are unwilling to breach the distance that separates us. Don’t get me wrong. Not for a minute do I think that the gap continues out of rudeness on anyone’s part. As a matter of fact, it is quite the opposite. It is the politeness of others that prevents the gap from being bridged.

It is similar to hearing of a neighbor who loses a loved one, is diagnosed with cancer or other serious illness, or some other tragedy that has fallen upon them. It seems to me that when people experience such adversity is when they are the loneliest and need the most interaction with others. Yet we avoid them. We are so fearful of offending their tender emotions that we avoid the discussion entirely… not knowing what to say. All the while they just want to talk to someone about it.

It is amazing to me how easy it is to be therapeutic to yourself and someone else by just caring enough to let them know that you are there and that you want to talk to them.

Kim was so kind and apologetic for “intruding,” but little does she know that it is that very conversation that may have provided just the lift that Traci needed that day.

Traci and I spoke of it later and agreed that the self introduction on Kim’s part was not seen as rudeness, but rather as kindness. And further interactions of this sort will only serve to make our communities more friendly and secure.

As Kim and I discussed the issue further we mentioned that a relationship must start somewhere. On Sunday her relationship with Traci and the Lopez family began. For all we know they will continue to be dear friends 40 years from now, and it all began with one woman having courage enough to breach the emotional divide at the Rogers Ranch pool, and one woman being receptive to it. This is again one of the lessons that Ava’s story can teach us.

A recurrent theme has been our emotional availability and interconnectedness with others. We just have to open our eyes to it and be there emotionally to let it happen. Sometimes we’ll initiate it… sometimes we’ll receive it… but both have to be there for it to happen. Make yourself available to others and make this a better place.

Ava, the party waits for you.

fw

From the Lopez family to YOU - Thank You!

I am writing tonight to express my gratitude towards two very important people. I was picking up my daughter and her friend from an event in our neighborhood and a person approached me. The one and only other time I met face to face with this person was the night that he held my daughters head and neck so that she was able to breathe as adequately as possible after having been plowed down by a drunk driver in my neighborhood. There were two people that arrived immediately to the scene, one being a very amazing woman named Jennifer and another named Scott, the person I speak of above. I almost hesitated writing this letter because there are so many people that I am so appreciative of. However, whenever I think back to the accident, which by the way is on a daily basis, there are several images I can’t get out of my mind and two of them are Jennifer and Scott. Without the help of both Scott and Jennifer I am almost certain we would not be where we are today. Ava would not be where she is today. If I have not done so already I wanted to say Thank You for being where you both were the evening of April 23rd. Thank you for taking part in helping to save my daughter’s life.

I am thankful to everyone for their continued support. My Aunt was able to stay with Ava in the later part of her hospitalization during the evenings so that Manny and I could be home with Jack and Isa. My Mom has been with us since the beginning of June and has been a tremendous help. We have other family members coming back next month which we are thankful for. To all of our friends EVERYWHERE thank you for all of the continued prayers and support. The meals have been much needed and appreciated, the car pooling with Jack and Isa has been so helpful and has enabled them to enjoy some of the fun activities summer has to offer. To the medical community, which includes too many individuals to even begin to name, our deepest appreciation for continued efforts in getting our daughter back to the life she once lived so innocently.

To all of Ava’s angels……thank you and good night!

Fred….the party is getting closer!

Memorable Father's Day

My family had the privilege of spending Father’s Day with the Lopez family. This is not anything new for us. Most holidays that we are in town together, we spend together. Mother’s Day and Father’s Day have been routine for us for the past several years. For obvious reasons this year was more special to all of us.

I could go on for pages choosing words and phrases that would try to match the grandeur of the day, but instead I decided to spend my time learning how to convert, edit, and upload a short video clip that was taken at the Lopez household on Father’s Day. Given the heartbreak of the evening of the 23rd of April, a mere two months ago, you will see why I thought that it was more appropriate to add this video rather than a neatly crafted collection of letters.

http://www.youtube.com/watch?v=X_CTX4xa08w

I have also added some pictures that were taken that day. I hope that you find them uplifting and that they prompt you to go and hug someone that is very dear to you.

Ava, the party waits for you.

fw.

We are thankful

Today was a good day for several reasons. It has been a little over 7 weeks since Isa, Ava and I were hit by a drunk driver in our neighborhood……today is the first time Ava has sat by herself in over 7 weeks. Manny was playing with Ava and the other kids when all of a sudden he was yelling my name. I quickly stopped what I was doing and ran to the room where I saw Ava sitting in front of Manny. While this may not seem as a big deal, to us it was another hurdle that she has had to overcome from this senseless tragedy. Ava is currently in physical therapy 5 times a week, occupational therapy 3 times a week, speech therapy once a week and vision therapy once a week. We have also been blessed with an amazing woman in our neighborhood that has offered to help Ava twice a week with occupational therapy. Rosie has a background in OT and like many other people during this entire process has offered her services to help Ava get back to the little girl that we all love so much. Today I was able to enjoy the time I spent with Isa and Ava at the pool. Something I often have taken for granted, I now cherish. Jack was able to spend time with a friend and came back at the end of the day and seemed revived. I was able to put all three of my children to sleep tonight with smiles on their faces…..for this I am thankful.

Our day started by attending church at Oak Hills. There was a motivational speaker at the church today. Many of you may know of him, Bruce Bowen from the San Antonio Spurs. He had an incredible message that I think is worth mentioning. He said ‘you should never give up even when you are faced with life’s challenges’. I saw a man tell us the story of his life and how he faced all of life’s challenges and because of that has become a loving father, husband and very successful NBA basketball player. This accident has resulted in numerous challenges (too many to even count). Just like he did, we too will face life’s challenges knowing that things will get better. Although Manny will never be an NBA basketball player, our family will have the most important thing life has to offer…each other

We were able to meet Bruce Bowen and share Ava’s story. We left knowing that he was wearing an “All for Ava” bracelet and were just so touched to have another person looking out for her. It is because of all of you that we are where we are today. A far cry from where we were April 23rd. Does this mean that I have forgotten the reason why we are even here to begin with? Absolutely not. I am thankful though that I can hug each one of my children every night and tell them that I love them…..something I never thought would happen again.

Each day will bring a new challenge but with challenge will come change and this is how we will get Ava back one step at a time.

To all of Ava’s angels…..THANK YOU!

Love,
Traci

Life at home with Ava

In case you missed the news stories that aired over the last few days since Ava's homecoming, here are the links for the videos that have been posted:

http://www.kens5.com/homepage/tab3/stories/KENS20090610-AvaLopezRecovery.681101c7.html

http://www.ksat.com/video/19709637/index.html

Please continue to pray for Ava's recovery and for the family's strength and patience as they adapt to their new life.

Golf, anyone?

The Sharing & Caring Foundation is a charitable organization started by Keller Williams associates with the mission of responding to meet the needs of persons within the local community. Their mission statement states that “success will result through our faith, hope and love of all God has created. We hope to create opportunity as we breathe life into unfortunate circumstances and change the lives of those we will touch.”

The Caring and Sharing Foundation sponsors a golf tournament every year with the proceeds going to support various causes. This year the tournament is being held on Monday, June 29th at Fair Oaks Golf Club. A portion of the proceeds are being donated for Ava’s recovery.
Each Player receives a “Member For A Day” Replay Certificate from Fair Oaks Ranch Golf & Country Club, Breakfast Buffet, Lunch, 2 Drink Tickets, A Goodie Bag, a T-Shirt, Golf Cart, Warm Up Balls, Bag Service, Professional Scoring, Hole In One Opportunity and Green Fee’s.

Fair Oaks Ranch Golf Course & Country Club
Monday June 29, 2009
Registration at 8:00 AM and Shot Gun at 10:00 AM
Lunch at approximately 3:00 PM with Awards to Follow

You can get more information about the golf tournament and registration at http://www.sharingandcaring.org/.

Ava is home!

I am sure that most of you are aware by now that Ava returned home on Friday. There was a small, intentionally unannounced “welcome home” at the Roger’s Ranch community pool on Friday afternoon. Many people from the community were there to welcome Ava and the Lopez family and to let them know that they have been thinking of them and praying for them. As Ava was brought in to the pool area, an applause broke-out.

The applause was warming not only because of the community heartbreak that has been felt over these past six weeks, but also because Ava’s personality began to show itself to the community. As the applause continued, Ava waved like the homecoming queen sitting on the top of a convertible’s backseat during a parade. She is a character… and there are many people who are breathing a heavy sigh of relief to see these pieces of Ava’s character re-emerge.
Jennifer was telling me that when they took Ava home for the first time since 23Apr09, that there was no doubt as to whether or not she recognized her surroundings or seemed to feel comfortable. Upon entering the Lopez’s house a tiled hallway extends straight ahead until it opens up into a carpeted sitting area with a high vaulted ceiling and a connected, open kitchen. As you enter the sitting room there are a collection of children’s toys immediately to your left, on the floor. Upon entering the room, Ava immediately started reaching for the toys as if there was no doubt who they belonged to or whether or not she could play with them. These were her toys… and she knew it. Welcome home Ava.

The Lopez’s spent much of the weekend like any other family in June… poolside. If you were unaware of the tribulations that had fallen upon this family, then you would not think too much of seeing them at the pool… Jack swimming with his friends... Manny and Traci trying to teach Isa how to swim… Grandma sitting in a chair on the side of the pool holding the baby and watching the others from under the shade of the pavilion. Much of the time Manny or Traci would hold Ava and twirl around with her in the chest deep waters of the pool. To the outsider, there is nothing particularly different about this family, but to those of us who know… we know that there is something very special about this family frolicking in the pool in early June.
“Well what about ‘Ava, the party waits for you?’ Why wasn’t there more fanfare?” Well the party does wait for Ava, and while she has returned to her home, her rehabilitation continues and there is still much healing that is left to be done.

Lilliana Story and I were talking earlier today. She recounted to me that she was at an unrelated function and happened to meet someone who was on the Anesthesia team that helped care for Ava the night that she came to University Hospital. This person had not particularly followed along since that time. Lillian told her that Ava came home and gave an update regarding her nothing but miraculous, on-going recovery. The reply was essentially, “SHE IS ALIVE?”

Oh yes, Ava is alive. And of course I do not mean in the “her heart continues to beat” sense. Ava is ALIVE!!! Like “she will live her life and be a testament to this time in all of our lives” sense. She will be a testament to the invincibility of youth…of hope…of love…of determination…of prayer. She will one day have children of her own, and grandchildren. And she will be the matriarch to an entire lineage of people who almost never existed. And you should smile… knowing that you helped make it so.

As for Ava’s party, there will be one. It will be well publicized through this and other venues and all will be invited, but it is still a little early yet. Once a few more uncertainties are resolved, then we will start talking party plans. Everyone has been so very gracious and respectful through this trying ordeal. I am sure that everyone understands and anxiously awaits the “please come and celebrate with us the miracle of Ava’s life…”

While laughter has returned to the Lopez house, much work remains to be done. Sincerest appreciation for your continued prayers, support, generosity, and encouragement. Keep it coming.

Ava, the party waits for you.

fw.

Ava is coming home!!!

Ava’s recovery has continued to be stellar. She is now able to sit in a high-chair and feed herself. Her body strength continues to improve, which allows her to sit-up for longer periods of time. She still does not have the strength in her legs to support her body weight, but this will improve with time… especially now with the assistance of the KidWalk.

Ava is using the KidWalk daily. Currently she moves by extending her legs in-front of her which consequently pushes the KidWalk backwards. This is a natural progression for kids as they learn to navigate the walker and improve their ability to get around and explore her environment. The KidWalk is especially nice because it does not require the use of her hands. She can get around and continue to touch and feel things in her environment, which helps to encourage her to move around. All of this exercises her lower body more and gets her one step closer to walking without it. Then it will get passed on to another child who will one day learn to walk with it… and then another… and another… and so on.

While all of this is great news… it pales in comparison to this…

AVA IS COMING HOME ON FRIDAY!!!!

Yes! It is true! Her recovery has been progressing so well that she is anticipated to be released from Christa Santa Rosa Hospital Friday afternoon following the completion of her physical therapy sessions that day.

This is an amazing recovery in an amazingly short period of time. Granted she will still require extensive physical therapy, but she is coming home!!

72 hours… check
Extubation… check
Out of the PICU… check
Alert and talking… check
Eating… check
Out of the hospital… check (well, should be on Friday)
So what else is left other than walking?

As we have discussed before, Ava had a right occipital lobe infarct (dead brain tissue on the back right portion of her brain). This area is primarily responsible for vision. I am sure that many of you have heard that the right side of your body is controlled by the left side of your brain and vice-versa. The vision works similarly, but different.

You look with each eye but your brain merges the images from each eye together so that you only see one thing; otherwise you would have double vision all of the time. Essentially, when you look straight ahead everything to your left is seen by the right side of the retina in each eye, and everything to your right is seen by the left side of each retina. Your brain then merges all the stuff that you see to your right in the left occipital lobe and merges all the stuff that you see to your left in the right occipital lobe. As above, a significant portion of Ava’s right occipital lobe died as a result of her injuries from 23Apr09. So if the right occipital lobe is damaged, then this would affect things that are being seen by the right side of each retina. The right side of each retina actually sees the things that are in your left visual field. Because of this injury Ava cannot see things that are to her left, if she is looking straight ahead. This is called “Bilateral Left Hemianopsia.” Bilateral – both eyes. Left - left visual field. Hemi – half of her visual field. Anopsia – no vision… Bilateral Left Hemianopsia.

This is what we need to continue to pray for… her vision.

It is expected that given her young age that she is likely to recover from this too, but until it happens, she is still without complete vision and is not yet whole again. We need to continue to pray for her, for them, for her vision, and for her continued recovery.

Much appreciation for your continued prayers, support, generosity, and encouragement. Keep it coming.

Ava, the party waits for you.

fw.

Ava's KidWalk is a reality

Sorry for the long interval since our last update. This one will be short, but with nothing but good news.

Thanks to all of you, Ava’s KidWalk is a reality. She looks amazing, and all of you have been so instrumental in helping her make it this far. If you are still interested in helping financially, you can contribute via the donate button on this blog. The Lopez’s are exploring starting a foundation whose mission will be to help children and families affected by pediatric head trauma.

Ava continues to make improvements every day. She had the feeding tube removed at the end of this past week. She now has no medical support devices sustaining her. She is doing it all on her own. She is gaining more strength in her torso and is able to sit up in a high chair and be fed.
Another first…Manny and Traci told me that they heard her laugh for the first time today since her injury on 23Apr09. It was so refreshing to see more levity return to their lives as they described her giggle. While we did not speak of it, I am sure that part of it is a sigh of relief as the reality of the return of Ava’s personality is starting to show itself more and more. How wonderful to have come so far in such a relatively short period of time, especially given the severity of her injuries.

Sincerest appreciation continues to be extended to all of you for following along, spreading the word, contributing in whatever way you have been able, and praying for Ava and the Lopez family. You cannot be thanked enough for your thoughts, love, and support. Please keep it up.

Ava, the party waits for you.

fw.

Lemonade for Ava

Nadia Soufi may be just a child, but she was determined to do her part in raising money for Ava's KidWalk system. She proudly set up a lemonade stand at the Rogers Ranch pool grossing $200.00 towards this great cause. A big thank you to Nadia, her friends and all those that contributed to making this a huge success.

YOU can help!

Kerri Thompson has done a fantastic job setting up the website with the donation link. It is really nice... complete with music and pictures.

The description for the KidWalk is in the right tool bar. The link to paypal for donation is at the bottom of the description.

http://avalopez.blogspot.com/

Thank you again for everything that you have provided to the Lopez family... hope.

I will not be writing again for a few days. Thank you all for being so wonderful.

Ava... the party waits for you.

fw.

Ava's need for a Kidwalk system

Yesterday I had said, “What’s left?” regarding Ava’s recovery. One of the big hurdles remaining is ambulation (walking, running). Currently Ava’s core body strength cannot support her to even sit up, but she does have some strength in her legs. Probably not enough to support her body, but enough to kick, and this should be enough to get things going. But how do we translate this into ambulating and exercising her muscles to increase strength so that she can eventually walk on her own?

Christa Santa Rosa Hospital has borrowed a medical device named “KidWalk,” which was developed in part by Stanford University. The device is very much like a wheel chair, but instead of having a chair-like seat, it is more like a forward facing bicycle seat. The seat is set low, at about the level of the wheelchair axles so that a small child’s feet can touch the ground. There is a back-brace/harness system that supports the child’s torso so that they can sit in the chair while their feet are on the ground, without having to support the weight of their body. Their legs can move and they can walk where they want to walk without requiring the strength or coordination that is required to walk without assistance. (I have included a link below so that you can see it in action).

Amazingly, I have been told that there is only one such device in all of south Texas for rehabilitation of children. The one that Ava has used at Christa Santa Rosa was brought as a temporary loaner from the device representative. It is shared between other hospitals in South Texas, and is not always available for Ava.

Psst… This is where the favor comes in…

We are wanting to buy one for Ava’s use during her rehabilitation. The cost? Base unit… about $3000. With all the bells and whistles… about $4000, or so. Detailed information, with pictures and a video demonstration of how this works/looks can be found at http://www.primeengineering.com/pages/products/kidWalk.html.

Once you see the video demonstration, then it does not take much to understand, “yes, this is what I would want for my own child if they were unable to walk on their own.”

The hope and expectation is that our prayer warriors will continue to deliver on Ava’s healing, and she will graduate from needing such a device. The Lopez’s will be donating the KidWalk to Christa Santa Rosa for use with other rehabilitating children, without concern for needing to rely on the instrument companies charity to bring it to the hospital and allow them to use it. This would be good not only for Ava, but many other children and families that are much less fortunate than us.

Kerri Thompson is setting up a separate blog (secondary to obstacles with donating directly from the Caringbridge website) with a link to a PayPal account for Ava. We have explored many options with how to handle this and keep coming up with certain roadblocks. Firstly, establishing a non-profit organization so that your donations could be tax deductible takes time, which takes away from the usable time for Ava’s rehabilitation. Secondly, directing the donations through Christa Santa Rosa also requires time and limits our ability to control the use of the funds for the intended purpose. Thirdly, directing the donations through some other organization may stand in opposition to some of the beliefs of others and again may limit the control of the funds for the intended purpose… getting Ava a KidWalk to assist in her rehabilitation. We should have a link to the blog posted tomorrow.

How much is needed? Only modest amounts, but we don’t want anyone donating money who is not in position to donate money. You all are great people and your interest in Ava’s story and offering prayers and words of encouragement to the Lopez’s is valued beyond measure. These are financially hard times for a lot of people right now. If you are tight for cash, then don’t even consider it… you are loved just the same. If you have a little money to spare, then contributing some of it to this cause will not only help Ava, but it will also help other children just like her in the near future.

What will you do if you come up short? Ava will have her chair (period).

What if there is an excess? Every dime donated will go to better the facilities that have been instrumental in Ava’s recovery. There is no plan to spend money that we don’t have, but suffice it to say that all of the money will be spent so that it will serve the betterment of many other children and families, not just the Lopez Family.

Is the donation tax-deductible? No. Unfortunately, time is important to us and has limited our ability to set up such an organization in a timely enough fashion that would allow the donation to be tax deductible.

Your prayers, acts of kindness, and encouragement have continued to sustain the Lopez family. Thank you again for continuing to be there for this most deserving family and for spreading the word “far and wide.” Keep passing the message along. Ava’s story continues to work in the most amazing ways and in the most unsuspected lives.

Ava, the party waits for you.

fw.

Preliminary ophthalmology results

The past few days were really good for Ava and the Lopez family. I had not mentioned everything over the past few days so let’s catch-up a little.

We have discussed Ava’s eyes and not being sure whether or not she is focusing on/tracking objects that are in her field of view. Given her occipital injury (the posterior part of the brain that is responsible for vision) this was a big question mark. That her eyes didn’t seem to be fixing on anything made it an even bigger question mark.

Ava had an ophthalmology exam last week (by the way, one of the questions on my ophthalmology rotation exam in medical school was “How do you spell Ophthalmology?” I'm telling you, med school was tough! It is O…P…H…T…H… In case you were interested). So at any rate the result of the exam was that she had no retinal or optic nerve atrophy. This was very reassuring because it gives her a good opportunity to rewire areas of her brain that may not be able to see. Everyone has a small blind spot on each retina. We never see it because the brain fills in the area with what our brain thinks should be there, the background pattern. The thought with Ava right now is that she has some blind spots and she is changing her direction of focus to try to see around the visual deficits that she currently has. As you can imagine this can be quite difficult. Your central area of vision is responsible for almost all of your visual acuity. Try looking at this “X” but read the words just two or three lines away from it. It is nearly impossible. Your central vision is critical, especially in a child that has all of her education ahead of her. Fortunately, she is young and her brain has a chance rewire and fix itself, better than ours would.

All in all, the ophthalmology appointment was reassuring. Ava still has a good chance of recovering what visual deficits that she has now. Weeks 4-6 after the injury tend to be the critical times for such recovery/injury. Last week was week 4. She will have another Ophthalmology exam this week and again next. This will give us more information.One of the more incredible developments has been the rapid improvement in muscle control of her head and neck. One week ago she had essentially no muscular neck tone. Today she went through a one hour long Physical Therapy session without needing any head or neck support. This is great for her and those caring for her and is one more box to check on her road to recovery.
Another box to check on our list is “eating.” Ava passed her swallow study earlier today. Yeah!!! Manny tells me that she went to town chowing on some pears, applesauce, mashed potatoes, peas and green beans earlier today. You would think that this girl hasn’t eaten in a month, the way she munched on those pears. Like Manny’s nose wouldn’t be enough to hold over the hungriest of babies. All kidding aside, I can only imagine how succulent pears would taste after not having eaten in a month.

She still has the feeding tube (which was switched to her left nostril to try to encourage her to grasp at it with her left hand) which will stay in place for the next several days to ensure that she will continue to tolerate solid foods well. She still has some difficulty swallowing thin liquids but this should improve as her tone increases.

So what is left?

Ava still has very little body tone and cannot sit up on her own, but 4 weeks ago she couldn’t breathe on her own. Three weeks ago she couldn’t move. Two weeks ago she couldn’t speak. One week ago she couldn’t hold her head up. Just imagine what amazing things she will be doing a month from now.

Please keep up the prayers and the Lopez encouragement. You all are doing a phenomenal job of helping this little girl recover.

Beatrice, your baby misses you… and so does Ava.

Ava, the party waits for you.fw.Tomorrow, I have a special favor to ask.

Pretrial hearing tomorrow

Housekeeping: Pretrial hearing tomorrow. 226th District Court in the Bexar County Court House at 300 Dolorosa. The court room is on the 2nd floor. If you are lost, then call District Court information at 335-2311/2011 (opens at 8am). Judge Sid Harley is presiding. The arraignment should occur between 8:30 and 9:00 am. It is intended for discovery of prosecutorial evidence. The accused may or may not be present. You are all welcomed and encouraged to come and show support and interest in this very important case. Bear in mind, this will not be like the drama of Law and Order. This is not the trial. This will likely be a quick proceeding and you may even miss it if you are not paying close attention. I mention this not to dissuade you from attending, but don’t want you to have too high of an expectation of what will be occurring tomorrow.

Beatrice's Devotion

Housekeeping: Kerri Thompson has opened up the June meal calendar for the Lopez family. Here is the necessary information: www.carecalendar.org

Calendar ID: 15804
Security Code: 9927

A quick Ava update: She continues to make small gains everyday and continues to gain slightly greater muscle control than days before. Most notably she is having more neck muscle control as is evidenced by how often she thrashes her head from side-to-side while lying down. As of yet she still does not have enough neck strength to hold her head upright, but this will come and we’ll be here to let you know when that happens.

Now, a much deserved, “thank you…”

A recurrent theme during this chronicle has been the heartache that a parent feels for their hurting child and at what lengths they would go to relieve them of that suffering. How easy it is to rationalize our own pain, but not the pain of our children. How easy it is to set aside your own interests for those of your children. How painful it is when you are unable to do it. How you ache internally with the realization that you must let them go, to travel their course alone.
There has been one person that has been hardly mentioned during the accounts that I have put on Caringbridge, that deserves special recognition for her efforts. She has been with Manny, Traci, Jack, Isa, and Ava every minute of every day since arriving in San Antonio in the early hours of 24Apr09… Manny’s mom, Beatrice.

Think of how difficult it would be in your own life if, without any advance warning, someone were to call you right now and say, “You need to be at the airport in one hour and you will be gone for the next month.” I know that in our own house it takes three days of preparation for a two day trip. Beatrice put her own life and work on hold in the few seconds that it took for her to be told of the trajedy that took place in her son’s family’s life. And I am certain that there was absolutely no hesitation in doing so.

Beatrice has been an unsung hero through much of this, burdening her own pain in silence. Many people who do not even know the Lopez family have been brought to tears by Ava’s story, and it is so easy for this to happen if all you do is think about a child that you love very dearly. Now imagine the pain if it really were that child. This is how it must be for her, yet she is often overlooked because her pain is “minimized” by the pain of Ava’s parents.

Beatrice has been there to help in whatever capacity she can… feeding, baths, bedtime routines, overnight stays in the hospital,… whatever… wherever… whenever.

There have been many contributors from both the Lopez and Southerington families, but tomorrow Beatrice returns to Los Angeles and leaving her son and his family. Tomorrow will likely bring a similar pain that she felt when first learning of this tragedy… an emptiness.
For those who are here in San Antonio please acknowledge her and let her know how much you care and appreciate her… and for those who will receive her again in Los Angeles… please acknowledge her and let her know how much you care and appreciate her. She deserves it more than any of the rest of us who are trying to lend support to this most deserving family.

Ava, the party waits for you.

fw

Scars from April 23rd

I would like to start this entry with an apology of sorts. Obviously, I am not with the Lopez’s every minute of every day and will miss some of the most touching moments that occur during Ava’s recovery, for that I apologize. Also, the writing works best for me if I just pick an emotion that I am having and go with it. This is what tonight’s entry is, and this is why I am apologizing. I wish that I could tell you that “She walked today!” but that hasn’t happened yet and I don’t have any further news of her recovery other than “SHE SPEAKS!” which should be enough to sustain us for awhile yet. You may even want to fire me after tonight’s entry because it may appear a bit melancholy. If you aren’t in the mood for it then you may want to wait for another entry.

Well, let’s get on with it.

A simple thing stood-out to me when we were visiting with Ava and Traci the other night, and my mind just wouldn’t let it go for some reason.

Last night I spoke of Traci getting out of the rocking chair so that Jennifer and Lilliana could hold Ava. Traci stood to the right of the head of Ava’s crib, while we stood and talked about a variety of things. Traci was wearing a form-fitting gray cotton pull-over shirt with half sleeves that came to the elbow. While we spoke, she would occasionally cross her arms and adjust the sleeve ever so slightly so that it would expose her elbows. Standing directly across from her it is nearly impossible not to notice her elbows… they are scraped and scarred from being thrown across her yard and into the fence or even concrete. They are a bright pink, like the color of red grapefruit. The linear streaks across her elbows are pitted on the right and remind me of the blood that dripped from it on the evening of the 23rd of April. There is a small divot that remains in the center of the skin on her right elbow that was a hole the size of a pencil eraser on the night of her injury. The “abrasion” was bad enough to bleed, but not so bad as to require cosmetic or functional repair. On the evening of the 23rd of April, this is one of the injuries that your eyes would have been drawn to, given the persistent slow bleed while she lay on the ER gurney. Maybe this is one of the reasons why my mind would not let it go the other night… I am reminded of it. But this is why I am talking about it.

The scars on her elbows are a reminder to Traci, and to those who know, of the way things are and the ways things could have been. The scars are a reminder to us of this healing process. They represent so many things. They represent the injury of the 23rd of April to the Lopez family and so many others. The fresh redness of them reminds us that while healing, the wounds (emotionally and physically) are still fresh and are occasionally tender. The scar represents to us that it is continuing to heal and that it is not yet finished. The scar will continue to remodel and strengthen the tissues that were once injured. The bright redness of it will slowly fade with time. The skin will not be so tender forever. It will soften and smooth as it heals itself. Eventually, she will even forget that they are there for brief moments of time, then longer and longer.

But unfortunately, or fortunately, being a scar… it will never fully go away. From my perspective this is fortunate. May it continue to serve as a reminder to Traci and to all those who glance upon it, of the preciousness and fragility of life. May we see them and give thanks, privately or publicly, that Ava is alive and for the treasures that you have been able to maintain in your own life.

I think of these scars on Traci’s elbows and think how proud she should be to bear them. While the rest of us require an intentional act to put on our Ava gear to show the world our support of her/them, Traci alone bears the physical scars. It is her mark. It is a symbol of strength, devotion, dedication,… and healing. May it be a reminder to all of us, and may she be proud of them.

Ava, the party waits for you.

fw.

Challenges

Tonight, let us talk Ava logistics.

As before, when you enter Ava’s room, there is a small entry way with a sink and vanity on your right. It is similar to a small hotel room in that you have to take a few steps in before it opens up into the rest of the room, only smaller. In Ava’s room, it opens to your right. There is a wooden rocking chair with a high back that is always hidden immediately behind the vanity (from the entrance) in the right corner of the room and right next to Ava’s hospital crib.

When we first entered the room on Tuesday evening, Traci was sitting in the rocking chair with Ava (at the end of this you will see some pictures on Lilliana’s slide show link of this very moment). Ava looks so big now, and it is further accentuated by Traci’s small frame. Logistically it can be sometimes difficult to transition from one position to another given Ava’s size and her very low/absent muscle tone and control of her head and extremities. As we have discussed before, in many respects she continues to function as if she is a newborn baby, requiring total care. It is often challenging enough to navigate tasks and positional changes with a newborn, but fortunately they are usually relatively light weight (10-15lbs, even aged a little) and small enough to cradle with one arm. As you will see with the slide show pictures, there is no way that you could cradle Ava with one arm, not to mention her weighing 25lbs.

When we (wiedenhoefers and Lilliana Story) were there the other night, Traci was wanting to get up from the rocking chair. It was obvious that it was not so logistically easy to do, which is only worsened by recovery from her own injuries. She was getting up so that Jennifer and Lilliana could sit and hold Ava. In helping with the transition to her bed a short while later, I could see how challenging this could be. It is one thing to watch someone do something… you know… “oh, I could do that.” Then you have to do it, and you think, “wow! That is a little more difficult than it looks!” This is how it is with moving Ava.

Firstly, you have to support her head/neck. Any person who has ever seen a baby knows this. Then the rest of the body… torso, arms, legs. Simple enough… when the baby is 20 inches long and weighs only 7 lbs! It is a whole different matter entirely when she is Ava’s size.

The thought process is something like this…“Okay, one hand behind the head.” Head goes forward. “Okay, maybe behind the neck.” Head goes back. “Okay, maybe somewhere in between.” Better. “Now, support her body… wow this kid is long…one hand behind her back…too low… too high… better… oh crap… what about her legs?... oh, my… there goes her arm… help!” Not that it is impossible, but this is no newborn, and I have held a lot of them. Fortunately she isn’t slippery, covered with amniotic fluid, vernix (that white cheesy stuff on a baby when it is born), and blood. Then it would be extremely difficult.

This is how things are. And this is how things are much of the day… baths, diaper changes, changing clothes, physical therapy, holding… a lot of holding.

I mention these things just to remind people of the little tasks of daily living that continue to go on and continue to present small challenges to this most wonderful family. It is not a plea for sympathy, as I know that the Lopez family is greatful to be where they are right now, but rather a reminder of how their life is different… at least for a while.

Here is the link to some great pictures that Lilliana took that evening…
www.liliannastoryslideshow.com/visitwithava
Ava, the party waits for you.
fw.

Ava spoke

I wrote the following last night and decided to wait to put it in until today…

It has been more than three weeks since Ava, Traci, and Isa were hit in their side yard. Ava is recovering slowly and with an unknown endpoint. I only mention it in such a fashion (with a pessimistic tone) because of the duration of time that it has been and the natural tendency to have emotional fluctuations and even a point of emotional exhaustion and frustration… but this is not what I have seen. Whenever you see Manny or Traci they are positive, upbeat, friendly, welcoming, encouraging, embracing, conversant, thankful, appreciative, and loving. You come to visit Ava and the atmosphere is similar to one that I have seen many times on the postpartum ward… a stream of revelers and well-wishers have come to join in the celebration. I am certainly not trying to imply that anyone is glad that this has happened, as much as it is that I am trying to convey the atmosphere in Ava’s hospital room. Whenever I have been over there, regardless of whom else is there visiting, the room has been filled with smiles, hugs, laughter, and pleasant conversation. And the more that I think about it, the more wonderful I think that it is. This is not a wake. We are not attending a funeral. Ava is alive and she improves with each passing day… this is and should be a celebration of life. And I think of Ava lying there, gradually registering her environment… gradually picking up and relearning the complicated social texture of the interactions and emotions around her… maybe not understanding the words but certainly understanding the tone of the emotions. Compassion… friendship… concern… love… laughter. If you were a fly-on-the-wall, then this is what you would see. If you were Ava, wouldn’t this be how you wanted the environment of your room to be? How could this positive energy be anything but helpful to her… to them… to all of us. As I write these words it makes me proud of all of you and makes me want to tell everyone else… “look at the great things that these people (you) are doing for this family!” You should be very proud because this loving environment has certainly served to prop up the Lopez family and allow them to continue to feed the positive energy that is felt when you enter that beautiful little girl’s room. I think how easy it would be to feel alone and losing hope without such support… but then there is you… writing, calling, visiting, sharing, hoping… spreading the word… praying…

While I do not feel so comfortable as to assume the emotions of Manny and Traci during such a difficult time, there is one thing that I truly feel that they would be in complete agreement with… that is… I know that if I were them, then I would say… “If I have done great things, then it is only because I have been lifted-up on the shoulders of giants… you.” Thank you for continuing to lift them up. You should be very proud of what you are doing for this very deserving family.

Ava… the party waits for you.

fw.

Then there was today…

Something occurred that I did not expect to happen for some time yet…

Manny was at the hospital by himself this morning, holding Ava. Part of Ava’s physical therapy is the equivalent to teasing. Give her a taste of her pacifier, then take it away from her. Leave it just out of her reach enough to have to try and get it… maybe just leaving it against her lips but not in her mouth… close enough that she knows that it is there but just centimeters away. Manny was doing a little “physical therapy” not letting her have her pacifier. She started to whine and whimper, even cry, then the unexpected… “Mama.” Then the “physical therapy” really started. “Say it again!... Say ‘Daddy.’”… “Dada.” AMAZING!!! There is just no better way to put it… AMAZING! AMAZING! AMAZING! And no one was there to witness it! Don’t worry it didn’t end there. Traci, Tina Frazier, Kym Pharris, Jeff Larkin and Manny were having lunch at the hospital together. Jeff was saying his goodbyes and had yet to hear her speak. Traci went to Ava and coached Ava, “Say bye-bye to Larkin.” Then… weakly…and slowly…“bye-bye.” AMAZING! AMAZING! AMAZING!

Ava continued to be coached, reiterating a variety of things… “Isa, Jack, Cali, peas (that’s please in baby speak).” AMAZING! AMAZING! AMAZING!

Jennifer called me crying this afternoon… “Ava spoke.” The visitor flood gates are sure to open now. I described a celebratory atmosphere in her room even before she spoke… it is gonna be Fiesta, Cinco de Mayo, the Chinese New Year, St Patrick’s Day, (and any other festive holiday that you want to include) all rolled-up into one. This is truly a day worth celebrating!!
We previously spoke of Traci’s heart melting when she got to hold Ava for the first time since her injury. I am sure that hearing Ava speak for the first time in more than three weeks made her heart fill with so much joy that she just wanted to erupt and yell down the hallway… “SHE SPOKE!!!”

Traci described this as “the best day of my life.”

AMAZING! AMAZING! AMAZING!

Ava, the party still waits for you, and thanks to today it is seeming a little closer now. Today we celebrate… tomorrow we forge ahead.

fw.

Ava's story continues to touch us all

I have continued to be impressed by the grace and indomitable spirit that the Lopez Family has continued to show through this strife. While there are many examples of this, one occurred during a conversation with Manny this evening.

We were talking of a friend of his and his wife that had come to visit with them earlier today. His friend had relayed information regarding Ava to another person who did not know the Lopez’s personally. He almost apologetically asked if that was okay, not knowing whether or not the Lopez family preferred for this to remain more private. Of course Manny’s reply was to spread the word… far and wide, but the message is not exactly what you would expect at first blush. It is deeper and more humanistic than “punishment for the offenders and preservation of life.” While these are certainly important messages to send, there is a deeper hope and desire that comes from Ava’s story…

Most of you probably do not even drink that often or that much. Most of you would probably never drive a vehicle if you were intoxicated or even had only one drink. So you are not where a life would be saved. This story doesn’t prevent you from doing anything that would result in the demise of another human being. This story is merely preaching to the choir… or is it?
Ava’s story has touched all of us. We have been more thoughtful and considerate of others. We have paused to take note of the precious lives that surround us, whether it is with our family, friends, neighbors, or even complete strangers. We have looked at our own children and thought how devastated our own lives would be if such a tragedy befell them and have tried to make them feel more loved as a result. We have come together as communities (including the on-line community) and have said, “we are here for you.” So maybe Ava’s story is saving lives in ways other than the mortality count… and passing her story along makes us all more humane and interconnected. Maybe Ava’s story will serve no purpose other than to make someone’s life better, if even just for a day. But isn’t that a worthwhile thing, too. Manny understands this. This is his hope… that Ava’s story touches the lives of others… and makes them better… however that may be.

Ava… the party waits for you.

fw.

Hungry for Daddy's nose

Ava has continued to shed some of the vestiges of her injury this week. Two major medical support devices remained. She has continued to wear a cervical spine collar, which given its small size looked downright adorable, but those of you who know Ava also know that Traci could dress her up in a potato sack, and she would still look adorable. The cervical collar was also pathetic, in that it reminds us of the tragedy that occurred on the evening of the 23rd of April, 2009, that should never have occurred. The cervical collar was placed two weeks ago to provide extra support to Ava’s neck due to a concern on the MRI that some of her neck ligaments were injured. She had further imaging studies done this week that allowed the doctors to feel comfortable in removing the C-collar.

A secondary benefit that the C-collar provided was supporting Ava’s head. (“Psst… Fred… I think that you just said that this is why she was wearing it in the first place.”) Let me explain… If you were in a car wreck, then you may have to wear a C-collar to prevent you from moving your head/neck in a way that could result in your paralysis; however, the muscles that control your head/neck still work fine. In Ava’s case she needed the C-collar to prevent injury to her spine; however, her neck muscles are not working so well and her head is floppy… like a newborn. The C-collar has provided support to her head, keeping it from being floppy when she is held. Not having this support may actually help with her rehabilitation some, given that she will now have to start using those muscles more.

The last major support medical device that she has is the nasogastric tube. The tube is about the diameter of the charging cord for your i-pod. Come-on. I know that you all have one and that it is probably right in front of you. It is even more similar to your charging cord given that it is almost a milky color, actually tan, given the tube feeds that are in it. The tube enters her right nostril and courses down into her stomach. The remainder of the tube is taped closely to her right cheek with a piece of very thin, clear tape. The tape is so thin that you cannot even tell that it is there unless you look very closely. It makes it appear as if the tubing is just stuck to the side of her face. The remainder of the tubing is often draped over her right ear and pillow and is connected to a bag hanging from an IV pole to the right of Ava’s bed. The bag is clear and contains a liquid that looks like a cappuccino.

When I was visiting with Ava yesterday, she would reach around the right side of her face with her right arm and catch the tubing, pulling it forward. Speaking from experience, it can be quite annoying having such a thing sticking out of your face and down your throat. Have you ever had a scratch in your throat? It is always there, irritating you, but you can do nothing about it. You swallow, hoping that it will rinse away, but it doesn’t. The swallow does nothing but make it ache more. Ugh!! The futility.

This device remains in order to feed Ava and keep her nourished. It will come out once she regains enough control of her pharynx (that area of your throat that is behind the uvula – the dangly thing in the back of your mouth). The pharynx is very important. Without ever having to think about it your pharynx/epiglottis is a very important sorting mechanism. It separates solids/liquids (sending them down the esophagus) from air. Sometimes people lose control of this function and their body doesn’t know when to close the airway and shunt solids/liquids down the esophagus. As you can imagine, this could be a very bad situation if your body is diverting food into your lungs, even just a little bit. Earlier this week Ava underwent a swallowing study to see how well her swallowing mechanism was working.

The swallowing study involves taking her to Radiology where a fluoroscopy study is done. This is a real-time x-ray where the doctors/speech pathologist will have her swallow liquids, crackers, etc that are coated with barium to see if they are going down the right way. They watch it real-time on a television screen right next to her. Ava did very well during the study, with everything going the right way, but at the end of the study a small amount went into her trachea and she didn’t cough. The fact that she didn’t cough is slightly problematic because if the feeding tube were discontinued and she aspirated her feeds, then possibly they wouldn’t know, because… she didn’t cough. They keep feeding, she keeps aspirating, no one knows… problem. As a result the feeding tube remained in place. Overall, the study was reassuring and will likely be repeated later this coming week. Given the strides that she is making, I hope and expect that the next time will be “normal” and the nasogastric tube will be out.

This is a necessary thing to get the feeding tube out for a variety of reasons, but also means that a new task will result… feeding. This task I am sure that Manny and Traci will be thankful to have, because it will be one more indicator of recovery. I also know that they have no shortage of people that would just love to sit with Ava and feed her. I am not quite so sure why mothers seem to love this task so much, but they do. I think that feeding is a continuation of nurturing/nourishing that is so endearing to mothers. Maybe the solitude and comfort of being with your child when they are so focused on you as their provider.

This reminds me... A few days ago Ava gave everyone a very good indicator of how ready she is to get rid of the nasogastric tube and have a Happy Meal. When I went to see the Lopez’s at the hospital yesterday, I noticed that Manny had a tiny red dot at the tip of his nose that looked very much like a pimple. As it turns out, he was holding Ava on Wednesday and was gently rubbing his cheek against hers, touching nose to nose, feeling the softness of her skin and lips with the tip of his nose… then CHOMP!!! Ava clamped down on the tip of his nose. The first solid food that she had had in weeks! While she may temporarily have many features similar to a newborn, she still has the teeth of an 18 month-old. One more indicator of recovery, and something that Manny is not soon to forget.

Ava has continued to make small gains everyday that are almost imperceptible to those that are closest to her, but are so very prominent to those who only see her occasionally. In our last entry regarding Ava’s recovery, we had discussed that she was kicking her legs, but was not very active with her arms. This has changed a lot during the past few days, now with seemingly purposeful movements. While she is not doing fine motor movements with her hands, such as picking up an object, she is using her arm to brush things away from her face and even used the back of her right hand to push her pacifier back into her mouth last night. These achievements may seem little but are very significant. It is like your newborn child making small coordinated movements. Each few days or so they are able to do some small task that they weren’t able to do before. This is thrilling as a parent for an otherwise healthy child that is expected to meet these milestones anyway. The “thrill” that the Lopez’s must feel with each fragment of a task that Ava re-accomplishes must be 10-fold greater… as it should be. These skills were taken from her… from them. Each one regained is a victory.

Fortunately for the Lopez’s, Ava’s recovery has been meteoric up to this point, but now we are in a rehabilitation phase. No one knows exactly what to expect, including the providers that are caring for Ava. There is no time frame for expectation of meeting certain milestones. This is indeed frustrating for everyone involved. It reminds me of being a child and the agonizing wait for those things that you so very much desired… Christmas, spring break, summer vacation, a party, etc. They seemed so far away. I knew exactly what they were like and couldn’t wait for them to come. I could picture the joy that I would feel when they finally arrived. But no amount of “wanting” would make it happen any sooner. This is how it is with Ava’s recovery, with one very unfortunate twist… no one knows the date that she will be considered “fully recovered.” The waiting would be so much more tolerable if we at least knew how long we had to wait. But not to worry, it will happen… and we will still be here. Ava… the party waits for you.

fw.

Lopez' heartfelt thank you

Dear Ava's Angels,

Over the past 3 weeks Ava has shown a miraculous ability to survive the horrific trauma that threatened to take her life. Our focus during this time has been solely placed on Ava, yet we realize that the reason that she has been doing so well is because of the prayers that all of you have been saying for her and our family. We have felt that we have been under water for the past 3 weeks and just now have come up for air. As I sit here next to a medically stable Ava late at night we have so many people to thank. There are so many that have been there for us that we prefer not to name anyone for fear of leaving someone out. Please understand that our family is eternally grateful to all of you that have supported us and prayed for Ava. The people include family, old friends, recent friends, and people who have never met us. Thank you to all of you that read this website on a daily basis and have provided such wonderful heartfelt comments.

Why a tragedy like this has to occur may never make sense to any of us, but it is our responsibility that some good come from this. Three weeks ago there was “a good chance” that Ava would not survive. Today she is well on her way to a hopefully full recovery. We know the recovery process will be long, but at least she is here to go through the process. There are many families that have been less fortunate. The story of Ava has touched thousands of people all over the country. Let’s use that power to support MADD and strengthen the consequences of reckless acts of drinking and driving. Locally we can contact our District Attorneys office as well as State Senators Wentworth and Van De Putte to let them know that this senseless act will not go unpunished and that we will not rest until justice is served. God and our family will eventually forgive the person that nearly killed three members of our family, but in a free society there are consequences for reckless acts.

On a lighter note, one person that must be named for their efforts is the primary author of this Caringbridge journal, Fred. For those that don’t know Fred, I’m sure you would like to know a bit about him. Fred and I met about 15 years ago in medical school. Fred was president of our class all 4 years which was no small accomplishment considering the strong personalities within a medical school class. Fred like Ava is a survivor. Fred was diagnosed with an advanced colon cancer almost 6 years ago. He underwent extensive therapy which he documented on his own Caringbridge site back then which I followed daily being moved by his ease of the written word as he described his struggles with the therapy. Fred, as you can imagine has an amazing family and incredible friends that supported him during his fight against cancer, just as Ava is supported by all of you. To give you an idea of Fred’s dedication to his family, Fred became an Ob/Gyn after medical school. Five years after completing his residency, Fred realized that his job was keeping him away from his family (wife Jennifer, two daughters Abbie and Sadie, and two sons Nathaniel and Evan). Instead of just saying oh well, Fred took the brave action to apply for a radiology residency here in San Antonio. So 10 years after graduating medical school, Fred is now a 2nd year resident in Radiology with 3 more years to go after this one. So keep in mind as you read his updates that he is writing them as he is being an amazing dad and enduring the daily grind of being a resident. Thank you Fred for being an incredible friend!


Lastly, this Friday May15th Col Joe Brennan is starting his 6-7 month deployment to Afghanistan to be the Head and Neck surgeon at Baghram Air Base. Please pray for Joe’s beautiful family as the deployments are always harder on those back at home, and pray that Joe has a safe return home.

God bless you all for all that you have done.

The Lopez family.In case you haven't had a chance to see the amazing slideshow that Lilianna Story put together, please take a look at the following link:

www.liliannastoryslideshow.com/avarally

Also, be sure to check the previous post for t-shirt and the MADD walk info.

"All for Ava" t-shirts

Hello dear friends,

MADD has graciously agreed to handle the "All for Ava" shirt orders from this point forward. Please e-mail Jessica Cullitan at jessica.cullitan@madd.org for shirts. She will need your name, address, phone number, e-mail address and the size/quantity of shirts you're interested in. Shirts come in Youth - Small, Medium, Large, as well as Adult - S, M, L, XL, XXL. Payment needs to be received by MADD before order is placed. Also, MADD will place the order when they reach approx 150-200 shirt orders. Please send payments to the local San Antonio MADD office at 110 Broadway, Ste. 442 San Antonio, TX 78205. If you live locally in San Antonio, we ask that you please pick up your shirt(s) from the address listed above once you have heard from MADD that they are in. MADD can be reached at 210-349-0200. If you live outside of San Antonio, MADD will make arrangements to get shirts mailed to you, but there may be an additional charge for shipping. If you placed an order through Jennifer Smith over the past couple of days, please check your e-mail to see how to proceed with your order. A picture of the shirt has been added to the Photos tab within Caring Bridge.

We can't thank you enough for your continued prayers and support. Continue to proudly wear your pink shirts and Ava buttons. Everytime someone asks what the shirt or button is for, keep sharing Ava's story. It could save someone's life. This is the least we can do for the Lopez family. Next time you sit down to pray for Ava and her recovery, please say a special prayer of strength and patience for Ava's family.

Don't forget that it is not too late to register for the Walk Like MADD event this coming Saturday, May 16th at Brackenridge Park. For more information, please see the previous journal entry. If you don't live in the San Antonio area, check out the website below to see when the MADD walk will take place in your area.

http://support.madd.org/site/PageServer?pagename=wp1_cities

I know we will all be anxiously awaiting Fred's return to hear more about Ava's baby steps towards recovery.

Take Care