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Mother remains hopeful a year after son's critical injury

By Bianca Montes
May 31, 2014 at 12:31 a.m.
Updated June 1, 2014 at 1:01 a.m.

Niko Ramirez fights to gain control of his body during a tough  three-hour session at the Warm Springs Specialty Hospital rehabilitation facility. Working with occupational and physical therapists, Niko's mother, Doriann Ramirez, participates in the therapy as well as daily care and transportation.

Frustration sweeps across Nicholas "Niko" Ramirez's face as an occupational therapist massages his hands.

She patiently tries to relieve them from a clenched grasp. Muscle spasms are a side effect from Ramirez's brain injury, and although he made vast improvements at a rehabilitation center in Houston last year, a recent setback has the 22-year-old back at square one.

"You're helping me today," she tells him, looking at his mother for encouragement. "He's not fighting me today."

Doriann Ramirez tells the therapist her son had a good night's sleep last night, something she worries about nightly after he started to seize a few months ago.

He looks tired - his long eyelashes flutter in a battle against sleep, and he fights to keep his head rested on the back of his chair. He's frustrated.

Ramirez crashed his motorcycle in May 2013. He was hanging out with friends after being away on an oil rig for several months. In front of him, a friend drove an all-terrain vehicle, and when he slowed, Ramirez didn't notice. Ramirez struck the back rear tire of the vehicle and flipped several times before landing in a ditch headfirst. He wasn't wearing a helmet. The investigation into the wreck revealed the handle bar of his motorcycle also struck the right side of his head during the accident.

Starting over

He can't speak.

He can't move.

He has no way to communicate with the world, as if he were trapped inside his own body.

"We sit here a lot and think about how difficult it must be for him; he's claustrophobic, and he gets frustrated when he can't do something," his mother said "And I think, 'How do I laugh and not feel guilty? How do I smile?'"

It was just last summer that her son was able to kick his leg, give her a thumbs-up and communicate yes or no answers visually using a color system. His momentum during a two-month stay at the rehabilitation and research center TIRR Memorial Hermann in Houston was so progressive that his doctors stopped predicting his outcome.

"But I wanted more," his mother said. "If he was kicking one leg, I wasn't happy. I wanted him to kick both legs. If he was giving a thumbs-up on the right hand, I wanted both hands.

"I wanted more, and I was so focused on the more that I forgot about the now."

Her son's progress was seized last August when complications arose after a surgery to replace part of his skull that was removed. Every step forward they had made was completely erased.

"At this point, I'd take anything," she said.

Lessons learned

Ramirez is back in Victoria after being away at hospitals and rehabilitation centers for nine months. His goals at Warm Springs are similar to ones initially set when he arrived at Memorial Hermann last year: maintain an upright position, eye contact on command three out of five times and visually communicate yes-or-no answers using a colored-cone system.

While he is more aware because of several dives into an oxygen chamber, Doriann Ramirez said her son's motor and occupational skills are - by far - worse than ever.

Gena Irby, an occupational therapist assistant with Warm Springs Specialty Hospital in Victoria, continues to push Ramirez, despite his attempt to fall asleep during his therapy. She works a cone into his clenched hand, pulling his arm up in the air and telling him to pass it to his mother.

His hand drops.

She picks it back up.

"Give Mom the cone, Niko," she says again.

Doriann Ramirez still has faith in her son's recovery but also said she's learned to enjoy his small steps. Thinking back at his recovery time at TIRR, she relives the day he kicked his leg.

"He was probably jumping for joy inside," she said. "But I was just wishing he'd kicked both legs - I should have enjoyed the journey more, and I feel guilty. I should have enjoyed every moment of that."

One simple wish

Doriann Ramirez said she considers the possibility her son may never come out of his current state.

But she can't look at it like that, she said. "I'm no good to Niko when I'm sad and crying and unhappy. I'm good to him when I'm happy and motivated."

She said meeting other families with similar injuries has helped her outlook. As for the future, she wishes for one thing; for her son to be able to communicate yes or no.

"Are you in pain, Niko?


"Are you hungry?


"Niko, do you love me?


"Anything else I get beyond that is a bonus from God," she said.



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