Dec 25, 2008 4:58 pm US/Eastern
Mom Won't Let NH Son Die From Iraq Injuries
By Lindsay Peterson, The Tampa Tribune
TAMPA, Fla. (AP) ―
When the neurologist told Nelida Bagley her son wouldn't survive his brain injury, all she could do was scream.
"You're lying. My son is not going to die," she wailed into the telephone before throwing it against the wall.
Bagley's son, Jose Pequeno, a sergeant in the New Hampshire National Guard, had been ambushed while on patrol in Ramadi, Iraq. When a grenade exploded behind his head, he lost almost all the left side of his brain.
DEFIED EXPECTATIONS
But Pequeno, 34, defied the doctor's prediction. Within weeks he was off the ventilator, breathing on his own. Soon he was out of a coma, opening and closing his eyes. And this month, after 34 months and 17 surgeries in a half-dozen medical centers, he came home.
He was discharged from James A. Haley Veterans' Hospital, and his mother brought him to the family's newly renovated five-bedroom house in Land O' Lakes.
"No more nights in the hospital. No more," Bagley said as she rolled her son in his wheelchair onto the back patio. "You've got the trees to look at now. ... This is home, Jose. This is home."
As she stood with her hand on Pequeno's shoulder, friends and family gathered around. More than 150 people came to welcome him home, including representatives from U.S. Central Command at Tampa's MacDill Air Force Base and members of at least six veterans motorcycle clubs who lined the road holding U.S. flags as his van approached. Pequeno rode a motorcycle before he went to Iraq.
He is one of the most traumatically injured soldiers to return from the Iraq war, said Steven Scott, director of the Tampa VA hospital's Polytrauma Center. He can't speak, walk or lift his arms. His nourishment comes through a feeding tube. Two surgeries to rebuild his skull have failed because of infections.
COMMUNICATING WITH HIS FACE
But he's aware. His facial expressions tell his family and therapists when he's in pain and at peace. He grimaces when his sister plays rap music on the radio, never his favorite. When his 13-year-old daughter visits, he watches her every move.
"You can see the sparkling in his eyes," Bagley said.
Doctors say they don't know whether Pequeno will improve. But getting him out of the hospital is his best chance. If he can remain free of infection for a year, they will try one last time to replace the missing pieces of his skull, which could allow his brain to expand and possibly grow new nerve connections.
The family's expectations were high when Pequeno's rehabilitation began nearly three years ago. Over time, his early progress flagged, and so did their hopes. But "this is a whole new phase now," said his younger sister, Elizabeth Bagley, 24. "We keep thinking maybe. Maybe."
HIS STORY
Pequeno was a smart kid, but stubborn, his mother said. He was 7 when she married Robert Bagley, a former Marine, and at 17, he insisted she let him become a Marine, like Bagley and Bagley's father.
Robert Bagley said he always demanded a lot from Jose. "I didn't put up with any crap." And Pequeno respected that, even after the Bagleys divorced.
Years later, after both men had left the Marines, Pequeno followed his stepfather into the New Hampshire National Guard.
"He said he didn't think he'd been spending enough time with me," Robert Bagley said.
By that time, Pequeno had become something of a local celebrity. In 1996, he rescued a toddler who slipped from her parents' hands into a river below a cave known as the Lemon Squeezer. He then became police chief in the community of Sugar Hill, N.H., where a busy night was chasing down a loose bull with his sport-utility vehicle.
OFF TO IRAQ
When the Iraq war started, Pequeno was angry he wasn't among the first to be called up. So when the New Hampshire Guard was asked to provide members to fill out a brigade from Pennsylvania, he volunteered.
By early 2006, he had been in Iraq for nine months, part of a team that patrolled a main supply route to keep it clear of roadside bombs.
The afternoon of March 1, 2006, two truck bombs went off in front of an Iraqi police station near Pequeno's observation post. A fellow soldier, Sgt. Frank Sorrento, heard the explosion, then Pequeno's voice on the radio saying his patrol was getting hit with small-arms fire and rocket-propelled grenades.
"Then the radio shut off," Sorrento said.
A grenade had exploded inside the Humvee, killing the driver, Spc. Christopher Merchant of the Vermont National Guard, and blowing away part of Pequeno's skull.
Medic Sgt. Thomas Middleton ran to treat Pequeno when he saw him spitting blood, though he wondered whether he was doing the right thing.
"I didn't want to bring him back," he later told a reporter for New Hampshire National Guard magazine. But he continued treating Pequeno. "The impact on the platoon when we lose a man is immeasurable. It would be worse so with Pequeno. ... He was the spine of the platoon."
Three sleepless days and nights after getting the phone call that her son had been seriously hurt, Bagley waited to see him in a room at Bethesda Naval Medical Center in Maryland. She was frightened by the thought of what he would look like, but driven by one need: to feel the warmth of his skin under her hand.
When the nurse rolled him in, Bagley was relieved to recognize Pequeno's face, even though it was badly swollen. He was comatose, with wires and tubes coming out of his mouth, nose and head. Gauze bandages seemed to cover his entire upper body, but she found a patch of skin to touch on his right shoulder. And it was warm.
"We're here," she said to him. "We love you and you're going to be OK."
THE RECOVERY
Soon after that, the doctor treating Pequeno came to Bagley and told her for the second time that her son was not likely to live, and she called him a liar.
"You don't have the power to make that call," she said.
Pequeno's mother and sister stayed with him while he was in Bethesda, along with his wife and many visitors. At least one family member was at his bedside every minute. "We never left him alone. Always somebody was with him ... touching him, telling him we loved him," Bagley said.
On his 19th day in the United States, by now at Walter Reed Army Medical Center in Washington, Pequeno started breathing fully on his own.
"His strength, or should I say stubbornness, is showing through," his sister wrote March 23 in an online journal she kept on her brother's progress. "As usual all of his vitals are great and he's pullin' his own."
Family and friends gathered at Pequeno's bedside to talk, tell stories about him and provide as much stimulation as they could. His eyes flickered one afternoon when a friend asked if he could buy Pequeno's beloved Honda Shadow motorcycle for $1,000.
PHYSICAL THERAPY
He fought bacterial meningitis and staph infections, and endured surgeries to relieve the buildup of fluids in his brain. Bit by bit, he improved. By the end of April, he was in physical therapy.
"He is holding his head up and keeping his eyes open during the entire thing ... His hand squeezing seems to be a little sporadic lately but he's doing it!" his sister wrote in her online journal.
Though Pequeno's doctors were pessimistic, they still wanted him in therapy. The human brain is so flexible, even after a massive loss, it has the power to grow new nerve connections to recover lost functions.
Pequeno's wife, Kelley, returned to New Hampshire in July. Bagley and her daughter stayed with Pequeno, applying what they called "aggravation therapy." They tickled the tip of his nose and moved in close to talk to him, forehead to forehead, anything to get a reaction.
During a session July 23, a therapist had Pequeno on his stomach with a wedge under his upper body.
"They were trying to make him lift his head, and he was getting angry," Bagley said. She and her daughter were on the floor with him, urging him on.
"C'mon, Marine," his mother said. "You can do it."
Suddenly, Pequeno groaned "mohhhhhm" in the direction of his mother. Everyone in the room got quiet. Bagley cried.
That month, Pequeno was transferred to the Tampa veterans hospital, which had opened a special unit for traumatically injured Iraq war veterans.
Pequeno progressed, communicating with his facial expressions, groans, "ahhhs" and "aarrrs." In therapy Dec. 1, "he squeezed his nurse's hand, swallowed ... as well as moved his arm intentionally, as directed, in a resistant direction," his sister wrote.
But he still battled infections, and on many days he didn't seem to have the strength or will to work. When he didn't want to participate in something, he would close his eyes. But the family had learned that he couldn't ignore military commands, and he always obeyed his stepfather. So one day when Pequeno wouldn't open his eyes during therapy, Bagley called his stepfather and put him on a speaker phone.
"OK, Joey," Robert Bagley barked. "I want you to get your dead ass up and start doing some work."
"It was like night and day," Bagley said. "His head came up and his eyes opened."
Pequeno will always be a soldier, she said. He was so dedicated, she knows he would have chosen himself to be hurt above all the others who went to Iraq with him.
He was the oldest of that group. He told her, "I need to bring those guys home." And he did, she said.
"All of those guys are OK, and they're home."
As the months passed, Pequeno's progress in therapy leveled off. And the complications continued, including recurring infections and a condition that caused Pequeno's muscles to spasm. Doctors said he needed to have his skull rebuilt to protect what remained of his brain, but two attempts failed when infections set in after the surgeries.
After the first surgery, at Bethesda in July 2007, Pequeno's family and legal guardian decided he might be better off at a hospital in Boston, closer to his wife, Kelley, and the people who knew him in New Hampshire. But it wasn't close enough.
Kelley Pequeno had stayed near him in the first months after his injury, but over time, she visited less. Early on there were differences among family members over who had the authority to direct Pequeno's care, so a judge appointed a guardian. Kelley Pequeno said the judge recommended that she stay in New Hampshire, to provide a stable home for their son, 10, and daughter, 11.
"I know that being in Florida is the best thing for Jose right now so he can continue with therapy," she said recently. "I know his mother is doing a very good job taking care of him."
After the failure of Pequeno's second cranial surgery at Bethesda in April, he came back to the Tampa VA hospital. Doctors said they would try one last time to rebuild his skull, but he had to be infection-free for at least a year.
Bagley was staying at the Fisher House, a 21-room residence on the VA hospital grounds for families of soldiers in treatment. Her daughter was renting a house in Oldsmar and working in the hospital cafeteria.
They took Pequeno nearly everywhere they went, to the mall, the movies, even the beach. But Bagley began thinking they needed a home with Pequeno.
"What a chance of a life for him, ... for him to feel at home and not in a hospital after 33 months," Bagley said.
She and her daughter had paid close attention to Pequeno's care and learned how to move him from his wheelchair and feed him through his stomach tube.
The VA's Scott agreed the hospital could provide the advice and equipment she would need to make the transition.
But first the family had to get a house.
THE NEW HOME
They looked at dozens of places, Bagley said. They were too small or too expensive. After one more disappointing visit to a rental property, Bagley was explaining her situation to the owner, Terry Hanson. He was taken by the story and had an idea. What about his house?
Bagley fell in love with it. Five bedrooms, a pool, a peaceful backyard. There was room for Pequeno's 13-year-old daughter, Mercedes, from an earlier relationship. She had been visiting more often.
But the house needed modifications, wider doorways, a bigger bathroom to accommodate a shower chair and lift. Bagley could only rent it, she explained. Could she still make modifications?
Hanson made her an offer. He would lease the house to her if she would agree to buy it after a year. She said she couldn't promise she would have the money. Don't worry, he said, we'll find a way to work it out.
"I feel like we're taking your house out from under you," Bagley said. Hanson laughed. Well, yes, but he had another place to move to.
"I was just honored to be able to help," said Hanson, who runs a rug manufacturing company, Creative Rug Designs. "Being an Army veteran, I know how hard Jose has worked. I just wanted to help."
Without money for renovations, Bagley still had a long way to go. She began working with an organization that agreed to help. She doesn't want to name it because after several weeks, it backed out, leaving her nowhere.
"I was drowning," she said. "I didn't know where to turn."
She called a friend she had met while Pequeno was in treatment at Walter Reed.
"Let me make some calls," the friend offered.
Within days, Bagley's phone began ringing with calls from the American Legion, the Injured Marine Semper Fi fund and others; the Semper Fi fund had been helping her with living expenses since 2006.
"It was like fire. It just took off," she said.
With both groups helping, the work began, and the workers didn't just do the doorways and bathroom. They built shelves and an office for Bagley. They installed a camera in Pequeno's bedroom so his mother could watch him on a monitor at her bedside. They replaced screens around the lanai and built a sidewalk through the backyard for Pequeno.
In the corner of the yard, they put in a young oak tree.
"They planted oak because it's strong -- like Jose," Bagley said.
Describing the move recently, she began to cry, talking through her tears as she has learned to do.
"I was trying to explain to my daughter," she said, speaking slowly as she brought her hands in front of her heart. "All those doctors who told me he's not going to make it, all those times we went through when they said he's not going to be here. ... But it did happen. You see. ... We're making it. We're here."
(© 2010 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.)
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