“Just be there.” That’s the advice 26-year-old Thatcher Skolout gives to families with loved ones navigating a brain injury journey. His wife, parents and 1-year-old son haven’t left his side in the four months since he sustained brain trauma while working on a welding project in March.
“He was building a smoker out of a propane tank, and he was cutting into it when it ignited,” his wife, Shelby, said. “He had done several of these before, but for whatever reason, this time it blew up and he got blown back and landed on the ground. We actually don’t know exactly what happened because he was by himself. His dad found him about 30 minutes later.”
Thatcher was wearing protective gear, so he did not have any burns or broken bones from the accident. He was airlifted from his hometown of McCook to Kearney to CHI Health Good Samaritan Hospital for his brain injury. There are many levels of brain injury, and those who suffer the most severe traumatic brain injuries are often in a state where it is difficult to maintain wakefulness and experience impaired awareness. This is known as a disorder of consciousness. Thatcher was in a minimally conscious state, unable to walk, talk, eat or follow commands. Once he was medically stable, he came to Madonna Rehabilitation Hospitals’ specialized disorders of consciousness program. He had very little movement in his arms and legs, and no awareness of his surroundings.
“Our patients in the disorders of consciousness program are my favorite to work with,” Madison Walton, PT, DPT, a physical therapist, said. “There’s so much room for improvement that every little thing is a win. It’s really great for someone like Thatcher that he had such an involved family and they were there to celebrate all of those wins with us and with him.”
Emerging from Disorders of Consciousness: Waking up the Brain with Specialized Technology
Small victories, like moving a finger on command for the first time or tracking someone with your eyes, signal huge milestones in the early stages of brain injury recovery. Walton says she got most excited when Thatcher started making purposeful movements, indicating to her that he was starting to become more aware of his surroundings. “He reached out and turned down the volume on his iPad, and that was one of the first times we were like, ‘Wow, he’s really in there wanting to do stuff.’”
Even in a minimally conscious state, Thatcher’s care team got him up and moving, incorporating Madonna’s leading-edge technology to help him emerge.
“We like to get people who are in that disorders of consciousness program in the Lokomat as quickly as possible because we’ve found that if we get them in that machine and they feel that pattern of moving like they’re walking, it really helps trigger their brain to help wake them up a little faster.”
Walton also used the functional electrical stimulation (FES) bike with him to help his leg muscles contract and find pathways from his brain to move again. As he moved through Madonna’s continuum of care, he regained his range of motion and strength in his arms and legs. Every step of the way, his wife and parents have cheered him on. His wife says although it is sometimes painful to stretch his calf muscles to create a normal walking pattern, Thatcher pushes through, using his family as motivation. He wants to return to his life roles as a son, husband and father.
“He has always been such a good dad,” Shelby said. “Not only involved but so intentional about how he interacts with our son, Jack, and it’s been really cool to see that even through a brain injury, Thatcher is still that.”
Dad jokes and speech therapy: Family involvement propels progress
An exciting moment in Thatcher’s recovery came on his first day of speech therapy while in Madonna’s acute rehabilitation unit. He had made exceptional progress in Madonna’s Specialty Hospital, but he still hadn’t spoken yet
“The very first thing that happened when I walked into his room was that he said ‘hi’ to me,” Claire Dowling, MS, CCC-SLP, CBIS, a speech-language pathologist, said. “That was the first word he spoke since his accident. His parents started crying. Shelby started crying. I started crying, and I had just met him. I knew right then his trajectory was going to be a good one.”
Family involvement is strongly encouraged at Madonna. For Dowling, incorporating his loved ones helped make therapy more personal.
“Especially in the beginning, we were trying to get him to talk more and use those respiratory muscles so he could be really loud when he talked,” Dowling said. “Instead of just saying random phrases or random words, I had him say much more personal phrases to Mom, Dad, and Shelby. The reaction he got from them when he said, ‘I love you, Mom,’ or ‘Good morning, Mom,’ or ‘I love you, Shelby,’ was a huge motivator so having them here was a big blessing for him.”
Thatcher’s parents, Mike and Terri, said his family being present was crucial for his continued success. They joke that even when he wasn’t in therapy sessions, he was still in therapy with them. Evenings and weekends were times for them to practice the hands-on caregiver training they received at Madonna.
“The therapists are always really great about giving you homework to help that recovery journey go faster, so if you weren’t here to help them with that, I don’t know how they would advance as much,” Terri said. “Therapists would spend all day with them if they could, but they have other patients, so we can help fill in that gap.”
“I wouldn’t want to do it any other way,” Mike added. “We want to be there to see his advancements and his progress and remind him just how far he’s come, especially on the hard days.”
As he improved physically and rediscovered his voice, Thatcher’s family realized with delight he was still the same Thatcher. He could identify objects and answer questions. His sense of humor remains unchanged, and he has started to crack his famously bad dad jokes.
“I said, ‘I just want his spark to still be there,’ and it is,” Terri said. “The first time he made a joke, it took us all by surprise and we all thought he had maybe just misspoke, and he finally said, ‘I’m being funny.’
And we were all like, ‘Oh. Your humor is back!’ It’s neat to see he’s still there; he’s still his own personality, his loving self, and it’s a relief.”
For his high school sweetheart, those dad jokes are comforting.
“When we got here, I didn’t really know who he would be or if he would become the person that I fell in love with again, so seeing him be himself and get some of those characteristics back, even though it’s not 100% yet, is still a miracle,” Shelby said.
For members of his care team, Thatcher’s progress and his family’s involvement highlights a sense of professional and personal satisfaction.
“As therapists, it’s very easy to get into the mechanics of ‘this is therapy; these are the goals we want to meet,’” Dowling said. “But having that feedback from his family, ‘That’s him! That’s a joke he would make,’ or ‘That’s his sense of humor coming out,’ that’s really special to know that you’re getting not just those skills back, but the actual person back as well.”
Leaning on faith: Putting God at the center of recovery
Throughout Thatcher’s brain injury journey, Shelby has been documenting his progress and celebrating his successes through a CaringBridge website dedicated to his recovery. Many times, she talks about her Christian faith, and how Thatcher’s relationship with God has helped carry the entire family through the difficult times.
“I asked Thatcher if he had any advice to other families going through something similar, and he seriously said, ‘Good luck,’ which cracked me up,” Shelby said. “It’s a little true, because there’s no manual, but honestly, the one thing that has been able to get me through is my faith. There is seriously no other advice that I can give, except fully leaning on Jesus, because there’s nothing that can make this better other than that. It’s a rough road, but it’s a lot easier with Jesus walking with you.”
Through the CaringBridge website, she’s received words of support from around the world, and says she feels she’s realized her calling while walking this road with her husband.
“It gives me so much joy that I can share what we’re going through and the reason that we’re getting through it,” Shelby said. “Of course I want Thatcher to become who he was, because that’s who I fell in love with and I want so badly to get back to life, but at the same time, one of my number one goals has become sharing that story with people and hoping they look into having a relationship with God.”
Shelby says she appreciated Madonna’s holistic approach to care, treating the whole person physically, mentally, emotionally and spiritually. She’s also felt the love and prayers of her community as Thatcher continues to heal in God’s timing.
“I just have a new perspective I guess, and things that used to matter, don’t,” she said. “It’s cool seeing God’s perspective in our lives instead of things that we want so badly for ourselves. Not until you have something happen as big as this, you realize what is important and that is getting right with God.”
Moving forward: Working toward returning home
With an ultimate goal of returning home to his family and friends in McCook, Thatcher has taken the next step in his brain injury recovery. With his family by his side, he recently transitioned to Quality Living Inc., (QLI) where he is building on all the skills he relearned at Madonna.
“I’m sad to leave Madonna because I just feel so connected here and everybody has made us feel like we’re part of their family,” Shelby said. “But, at the same time, I’m extremely excited to go to the next step because it means we’re moving forward. We’re going to a good place and Madonna has helped us get there.”