Roan Mountain boy recovering miraculously from brain injury

By Julie Fann
star staff

If you believe in "coincidences," see if this one qualifies.
   On July 20, 2000, Josh Dugger, of Roan Mountain, was seriously injured in a car accident on Highway 19E. The only qualified person immediately on the scene to help him happened to be a doctor who normally doesn't travel that particular rural route. Josh, who was eight years old at the time, had stopped breathing, and reviving him required medical skill.
   "I normally wouldn't have been there. It was a fluke thing. I thought he was going to die at the scene. As soon as I got there, I called for a helicopter," said Dr. Barker, an Internal Medicine physician who practices in Roan Mountain. "He's one of my best saves."
   Barker said Josh's airway was blocked by a piece of bubblegum, which he had to dislodge. He then placed a tube in his throat so that he could breath. Johnny Ledford, Carter County Rescue Squad volunteer, helped pull Josh from the car, which involved removing the dashboard, and Josh was taken to the Johnson City Medical Center by Wings Air Rescue.
   "We nearly lost Josh a total of four times," said Kristi Dugger, Josh's stepmother. Kristi said that, when she arrived at JCMC, Ledford told her the last time he saw Josh that he was breathing. "That's when I knew it was bad. I went into shock," she said.
   The next morning, Kristi's parents, who were on vacation in Myrtle Beach, arrived at JCMC after being contacted by telephone. Josh had been going through a series of tests. "When the doctors wheeled him into the hall, well, he was unrecognizable. My father just started crying," Kristi said.
   Approximately 500 people from their small community in Roan Mountain were there to support Josh and his family. "We (she and her husband and Josh's father, Robert) spent that first night praying. If he wasn't going to live with any kind of quality of life, we wanted God to just take him home," she said. "It was the hardest prayer I've ever had to pray."
   Josh made it through the first 72 critical hours in a medicine-induced coma, connected to life support. Except for pressure on his brain, he was out of danger. Doctors said the left side of his brain had bled, making his right side weak. They decided to remove him from life support and reduce his medicine.
   "That was the day we actually felt good. We slept. But that night, a bruise on his brain stem bled and covered the part of the brain that controls the respiratory system. He stopped breathing and went into a complete coma. The nurse came to us crying. They put him back on life support," Kristi said.
   When Josh was removed from life support again, approximately a week later, doctors determined he needed extensive therapy that Johnson City couldn't provide. The bleeding on his brain was severe, and he was still in a coma. Kristi and Robert wanted Josh to have the best treatment possible and took him to Children's Healthcare of Atlanta.
   "From August until the first week of October, we got no response from him in Atlanta. All he could do was respond to 'yes' and 'no' cards by turning his eyes toward them. They brought pets in for pet therapy, and he did laugh once. His body accumulated so much medication there, though, he reacted, and we almost lost him again," Kristi said.
   Josh also underwent total reconstructive surgery to his face during the time he spent in Atlanta. Plastic surgeons repaired all of the bones in his cheeks, chin and forehead. "The whole right side of his face was pushed back an inch into his head. Both of his jawbones were shattered," Kristi said.
   After two months in Atlanta with very little response from Josh, the family returned home and underwent outpatient therapy at Quillen Rehabilitation Hospital. Josh was strapped into a wheelchair and had no control of any of his muscles. He couldn't lift his head.
   "Net Trans would pick him up for therapy, but he would get very agitated, having to wait. His blood pressure would go up, and he'd start crying," Kristi said. The family managed to have Josh admitted to Quillen Rehab and went through rigorous physical and speech therapy for two and a half months. The family also had to travel to Cincinnati, where a special biofeedback tool helped Josh regain control of his bowels and urine. Josh was fed through a feeding tube.
   The Duggers had a hospital bed in Josh's room at home, where Kristi administered his medications. During his time in outpatient and inpatient therapy, he began to speak again and eat on his own. Eventually, he started crawling with the help of an ambulatory device.
   Josh suffers from a condition termed apraxia, a disorganization of signals sent from the brain For example, if Josh wants to talk, instead, one side of his body may contract itself. "He has had to re-train his brain to do things the right way again," Kristi said.
   With a lot of patience and hard work from Josh, his parents and physicians, he returned to school in the fall of 2001 at the exact place he would normally be before the accident occurred. "He has no memory of anything before the accident except academics. He had finished the second grade, so he went back to third grade this year. He just started making new memories about nine months ago," Kristi said.
   Doctors expect Josh to have a 95 to 96 percent recovery from the injuries he suffered in the accident, but Kristi is determined that Josh will fully recover. "He responds to how he's treated. He reciprocates what is given to him. Some people think I'm being too hard on him sometimes, and maybe I am, but I want him to be able to live a full, independent life. If I always did everything for him, he would never become independent," she said.
   Josh still struggles with the apraxia and with walking; however, his level of improvement has been remarkable. Doctors told the Duggers that Josh is ahead of where he should be in the healing process.
   Josh's current struggle involves regaining full control of the right side of his body. He has completed speech therapy, however, when he talks, Josh's voice still sounds somewhat strained because his lungs don't completely fill with air. "That will just take time, as his body adjusts," Kristi said.
   What has been most amazing since the accident is the incredible amount of financial and emotional support Kristi said their family has received from the Roan Mountain community. "It has just been overwhelming, how people have responded and helped us. We're just so incredibly thankful."
   Upper Shell Creek Christian Church, with the help of Terry Lyons and Johnny Ledford, created a Josh Dugger Trust Fund through Carter County Bank. The community held benefit dinners, car washes and gospel concerts to raise money for the Duggers. "It was a real opportunity to see the community pull together," Johnny Ledford said.
   With the high cost of hospitalization, therapy and equipment, the Duggers wouldn't have made it without the help they have received from countless individuals who sacrificed themselves not only financially, but also emotionally. "We had people provide food for us, clean our home and mow our lawn. Just anything to help. It was incredible," Kristi said.
   Josh said he is also grateful. "I just want to thank everyone who helped me recover," he said.