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One step at a time
By MONIQUE FIELDS
© St. Petersburg Times, They looked like baby steps. Jayme Seybold was flanked by therapists as she slowly lifted her left leg and placed her foot on the floor. A moment passed, and she put her right foot in front of the left. She repeated the task and took measured steps, until she tired of the exercise and took a break. She walked about 15 feet Thursday. It took her 11 minutes. But she was walking, and her mother beamed. "Look at you, Jayme," said Candy Harman. "That's so good." When the therapy session ended, Jayme released a deep sigh, as if to say she was exhausted. It was not supposed to be this way. The Seminole 15-year-old should be enjoying her summer vacation and dreading the first day of school like most teenagers. Just a few months ago, Jayme was an active, turbulent teen who tested her mother's patience. That all changed in May when a motorist struck Jayme as she crossed 102nd Avenue N. In that instant, her left leg and clavicle were broken, her right arm was nearly severed and she was left with brain injuries so severe that her doctor hesitates to predict her future. The effects of the accident are painfully visible. The Seminole teenager can't speak or do anything for herself, and scars crisscross her arms and legs. At times, she appears aware of her surroundings. Other times, she looks like she is someplace far away. The good news is she is progressing, albeit slowly. She was unresponsive for weeks. In the three months she has been at Bayfront Medical Center, teen patients with less severe brain injuries have come and gone. Each day, Jayme attends comprehensive speech, physical and occupational therapy sessions. Each day, her therapists look for signs she is getting better. Each day, the stress of dealing with the ordeal takes a toll on her mother. Because she is unable to travel, Harman's national advertising agency, the Harman Marketing Group, is failing. She has been backed into a corner. She can save her business or her daughter. Not surprisingly, she chose Jayme. That decision has cost her in other ways. She battled with UnitedHealthcare to keep her daughter in Bayfront instead of sending her to a nursing home. To make matters worse, the insurance benefit to cover rehabilitation costs expired Friday. Citing patient confidentiality, a spokeswoman for UnitedHealthcare declined to comment on the specifics of Jayme's care. "We understand this is a very difficult situation," said Patt Reed, a marketing manager in the company's Tampa office. "We are working with, and will continue to work with, the family to provide Jayme the care she needs in accordance with the benefit plan purchased by her parent's employer." Medicaid will pick up where the insurance company left off, but based on Harman's salary, it will cost her nearly $2,500 a month -- roughly the amount of her take-home pay -- to make sure her daughter receives the care she needs. "It's a Catch-22," Harman said. "I'm almost better off quitting my job, getting on welfare and staying at home with Jayme than keeping my business." Already facing six-figure debt for business costs and some personal expenses, she is considering bankruptcy. Even worse, she is taking anti-depressants to deal with strong bouts of separation anxiety she suffers while away from her daughter. Still, with all the challenges of the last few months, she pushes her troubles aside and focuses on her daughter. She is able to do that, she said, because she possesses a strong faith in God. "You have to surrender everything to him and let him work," she said. To help with medical bills, friends of the family have organized a benefit. The event, complete with food, a motorcycle show, music, raffles and other games, begins at 2 p.m. Aug. 18 at Indian Motorcycles of Clearwater, 6170 Ulmerton Road, and T-Backs Lounge, 6250 Ulmerton Road. "I know this kid," said Dina Rufo, a good friend who is organizing the event. "She's meant to be here, that's for sure, because she still keeps improving." Jayme was struck by a car driven by 20-year-old Ryan Adams the evening of May 5. Though she had been grounded for running away, she was walking to a friend's house. Adams didn't see Jayme until he felt the impact as he rounded a curve on 102nd Avenue N about a quarter-mile west of Starkey Road. Harman doesn't blame Adams for the accident, and state troopers have said he will not face any charges. For eight weeks, Jayme was in a deep coma, unresponsive. The impact of the crash twisted her brain out of its normal position and quickly settled it back into place. It also cut her right arm down to the bone. Twice, doctors thought they would have to amputate her arm. They saved it, but it is unclear whether Jayme will ever be able to move it. Her recovery also has been hampered by pneumonia, several bladder infections and reconstructive surgeries needed for her arm. Her broken bones have healed, and she wears a brace on her left leg to stabilize its movement. Two weeks ago, Jayme turned a corner and started to improve. That's when she entered level four of the eight stages of a coma. She is confused and agitated. Life doesn't make sense to her, and it is frustrating. Progress comes in small doses. It came when Jayme grabbed a washcloth on command and helped her mother dress her. It came when she recognized her mother's voice and hugged her with her left arm, and it came when she used that same arm to push her therapists away because she had had enough of therapy. And she is young. Young brain injury patients are more likely than adults to think in different ways. In other words, her brain is more flexible and has the ability to reroute thought processes, said Kari Pedersen, a physical medicine and rehabilitation physician at Bayfront. The challenge for Jayme is to progress to the fifth stage of her coma, where she can better respond to commands and is less agitated, Pedersen said. "Most people get out of stage (four). It's just a matter of how long it takes," she said. While Jayme has made progress, her prognosis remains "grim," Pedersen said. Going back to school is going to be a challenge for Jayme, and she has a "pretty small chance" of becoming independent, Pedersen said. Harman sat in the room with Pedersen as she uttered those discouraging words. But she believes in God, not doctors. He wouldn't have brought Jayme all this way, she said, if he wasn't going to use her. Stages of a comaJayme Seybold, 15, is slowly progressing through the eight stages of a Coma. She is currently in level four. Level one: No response. Unresponsive to any stimulus. Level two: Generalized response. Limited, inconsistent, non-purposeful responses. Level three: Localized response. Purposeful responses; may follow simple commands, may focus on presented objects. Level four: Confused, agitated. Heightened state of activity; confusion, disorientation, aggressive behavior. Unable to do self-care. Unaware of present events. Agitation appears to be related to internal confusion. Level five: Confused, inappropriate, non-agitated. Appears alert, responds to commands. Distractible; does not concentrate on task. Agitated responses to external stimuli, verbally inappropriate. Does not learn new information. Level six: Confused appropriate: Good directed behavior; needs cueing. Can relearn old skills such as activities of daily living (ADL). Serious memory problems; some awareness of self and others. Level seven: Automatic appropriate. Robot-like appropriate behavior, minimal confusion; shallow recall; poor insight into condition. Initiate tasks but needs structure; poor judgment, problem solving and planning skills. Level eight: Purposeful Appropriate. Alert, oriented; recalls and integrates past events. Learns new activities and can continue without supervision. Independent in home and living skills, capable of driving, low stress tolerance. Defects with abstract reasonsing persist, may function at reduced levels in the community. Source: Ranchos Los Amigos in Downing, Calif.
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