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Update on Tristan Anderson Tristan Anderson, find clarinex 38 is another American citizen who was critically injured by Israeli troops during protests against Israel’s Wall in the West Bank village of Ni’lin in 2008. Find clarinex He was hit in his forehead by a new type of high velocity, find clarinex extended range teargas projectile.  Tristan was hit while standing with a fellow protester inside the village, find clarinex several hours after the army initially attacked a protest march of Ni’ilin’s residents (joined by international activists) who attempted to march onto their own lands in the vicinity of the wall. Find clarinex Anderson’s injury is part of a recent escalation in the army’s violent attempts to suppress Palestinian unarmed popular resistance to the occupation. Find clarinex Israeli troops have been using the new teargas canister since December 2008, find clarinex coinciding with the beginning of Israel’s ruthless assault on Gaza. Find clarinex The black canister, find clarinex labelled “40mm bullet, find clarinex special/extended range” in Hebrew, find clarinex has a range of over 400 meters, find clarinex emits a very faint sound when fired and leaves hardly any smoke tail at all – making it extremely difficult to avoid. Find clarinex The following responses to questions asked about Tristan's current condition was written by his partner, find clarinex Gabby. Find clarinex Is Tristan able to talk? Yes, find clarinex Tristan started talking in early December (shortly after he ripped out his tracheotomy tube). What is he saying? Is Tristan aware of who he is? Tristan knows who he is and he remembers his pre-injury life. Find clarinex He’s maintained a lot of specialized knowledge, find clarinex he tells stories, find clarinex he recognizes people in pictures, find clarinex he sings his favorite songs, find clarinex etc. Find clarinex His long term memory for life before the injury is generally excellent. What does his voice sound like? Is there heavy slurring? Does he have trouble formulating language? Tristan speaks clearly but softly. Find clarinex We have very good communication from him, find clarinex but it can be difficult to hear what he’s saying if there’s competing noise. Find clarinex While other cognitive functions have been impacted, find clarinex Tristan’s language abilities are more or less intact. Find clarinex He’s maintained adult grammar and vocabulary and has not needed therapy to re-learn language. How did Tristan communicate during the months before he was talking? Before he was talking, find clarinex Tristan communicated primarily with gestures and pantomime, find clarinex and also by writing and spelling words out on a communication board. Find clarinex (Although it’s very difficult to read his handwriting, find clarinex and it used to be much worse.) In earlier days (and for a long time) Tristan had very limited and sometimes inconsistent communication, find clarinex primarily with yes/no hand signals. Find clarinex Besides hand signals, find clarinex communication was also achieved by presenting objects or writing choices on a board and asking Tristan to point to the correct or desired one. Find clarinex In the bad old days, find clarinex Tristan could really only handle two options at a time. It's been said he was in a coma. Tristan was never in a coma, find clarinex but he lingered in a “minimally responsive” state for his first six to seven months post-injury. Find clarinex During this time, find clarinex life was almost completely dominated by medical complications and Tristan could only maintain wakefulness for a few minutes at a time. Find clarinex It was a horrible period with a lot of uncertainty about whether or not life would ever get better, find clarinex but he pulled through it and it has. What changed? In August Tristan had two surgeries, find clarinex a Cranioplasty (a reconstructive surgery on his skull) followed by a VP Shunt (to regulate the flow of Cerebrospinal Fluid in his body). Find clarinex Tristan started noticeably “waking up” more following the shunt surgery, find clarinex then experienced a very serious infection and went septic. Find clarinex He was put on high doses of intravenous anti-biotics for an extremely long time. Find clarinex Weeks later he emerged from the fevers and started making the slow climb out of the abyss. Has his personality changed? How has Tristan been most affected cognitively by the injury? Tristan has maintained a lot of his values and knowledge base as an activist and as the person we knew, find clarinex but he has been profoundly affected by the injury to his brain. Find clarinex Among other things, find clarinex he suffers from difficulties with impulse control and short term memory retrieval that impacts everything he does all the time. I’m afraid in answering this question that I’ll give an overly optimistic or an overly pessimistic view to the people who are reading it. Find clarinex At various times talking to friends, find clarinex I feel that I have done both. Find clarinex The fact is, find clarinex it’s complicated. Brain injury can make a person a bit of an enigma. For instance, find clarinex Tristan can legitimately play adult trivia games at a higher level than I can, find clarinex but he can’t play Connect Four or other simple children’s board games because he gets too caught up in putting all the pieces in and he can’t wait his turn. Tristan oscillates constantly between being knowledgeable and insightful to being unreasonable and child-like. Find clarinex There is never a time that I am unaware of his injury. What parts of his body and brain were injured on March 13, find clarinex 2009? Tristan was shot in the forehead above his right eye and was primarily injured in the right frontal lobe of his brain. Find clarinex He also suffered injury due to hemorrhaging and swelling during his first week in the ICU which very nearly took his life and did more damage. Find clarinex These secondary injuries caused significant harm to the right temporal lobe and to other areas of his brain. Tristan was also blinded in the right eye and the orbit (the bone surrounding this eye) was smashed to pieces. Find clarinex He is classified as having had a “severe” traumatic brain injury. How has he been affected physically? Tristan is hemiplegic. Find clarinex He is not completely paralyzed but has almost no movement at all in his left arm and left leg. Find clarinex This is particularly difficult for him because he was left handed. Tristan is also still recovering from the extensive damage done to his body by the months of being mostly bed-ridden and immobilized. Will he walk again? Tristan is in a wheelchair. Find clarinex Recently we’ve been seeing some movement come back in his left hip, find clarinex and his physical therapist feels optimistic that given proper therapy, find clarinex he will be able to regain some ability to walk. Find clarinex However, find clarinex she has warned that this may take years of work. What is daily life like for you guys at the Rehabilitation Center? On a good busy day, find clarinex the mornings are a flurry of activity as Tristan moves between physical, find clarinex speech and occupational therapy appointments. Find clarinex We squeeze in two meals and hopefully have time leftover for exercises and practice on a Standing Frame (a supported structure in the physical therapy room that lets Tristan’s body get used to standing again.) Sometimes we also use a recumbent style stationary exercise bike that Tristan can peddle actively using his right leg and passively with his left. In the early afternoon Tristan goes back to bed and rests for about two hours. Find clarinex He typically gets up about 4:00 or 4:30 and goes on a long walk with his father, find clarinex then comes back and eats dinner. Find clarinex He eats a lot of variations on rice and beans and vegetables and a lot of different kinds of soups. After dinner we figure out what to do with the rest of the evening. Find clarinex Sometimes Tristan works with a computer. Find clarinex Other times we play card games, find clarinex board games, find clarinex stuff like that. Find clarinex We try to get him used to operating his wheel chair for himself. Find clarinex Sometimes we work him pretty hard, find clarinex other times we just hang out. Find clarinex We read to each other a lot, find clarinex including some of Tristan’s old writings. We try to keep him company here and do something in between “work” and “play” in the free time we have. Find clarinex Mike, find clarinex Nancy, find clarinex and I have no lives at all. Find clarinex We’re here at the hospital pretty much all the time. Does he ever get out of the hospital? Not very often, find clarinex but sometimes. Find clarinex We try to get out on the weekends. How is he handling this emotionally? For better or worse, find clarinex Tristan has never heavily grieved over his injury. Find clarinex He is very aware of ways that the injury has affected him physically, find clarinex but less aware or accepting of the cognitive repercussions. In the last several months we’ve seen him slowly start to get more in touch with his feelings, find clarinex and I believe this will continue to develop with time. Are you still seeing improvement in his abilities? Yes. Is he still in critical condition? No, find clarinex at this point, find clarinex Tristan is in the post-acute stage of his injury. Find clarinex He’s living in a hospital because he gets rehabilitation there. Is he pretty much independent now or does he need a lot of help? He needs a lot of help. What’s happening with the court cases? There are two court cases, find clarinex a criminal case and a civil case. As of now, find clarinex the Israeli Police who investigated Tristan’s shooting have closed the case without bringing criminal charges against anyone involved. Find clarinex The investigation has been widely criticized as a sham, find clarinex and we are appealing this decision. (There was a misleading article published by Ha’aretz entitled “State to Re-investigate Wounding of U.S. Find clarinex Activist”, find clarinex which was spread all over the internet and gave the false impression that the Israeli state was re-opening Tristan’s case. Find clarinex In fact all that happened is that our lawyers submitted an appeal and the other side is legally obliged to accept our paperwork, find clarinex so they did. Find clarinex That’s it.) Besides the criminal case, find clarinex there is also a civil case which Tristan’s family is bringing against the Israeli military to help cover the lifetime of medical expenses, find clarinex lost wages, find clarinex and continuing care that Tristan will need. Find clarinex We have been warned that the civil case is likely to take years before coming to fruition. Find clarinex (Rachel Corries’ civil case, find clarinex filed in 2005, find clarinex first made it in to court here about a month and a half ago, find clarinex which is appalling.) What is the basis of your appeal to re-open the criminal case? The investigation into Tristan’s shooting is a perfect illustration of why the police and the army can not be trusted to investigate themselves. The investigators, find clarinex for instance, find clarinex never even bothered to go to the scene where the shooting took place. Find clarinex No physical evidence was ever collected. Additionally, find clarinex eye witnesses uniformly testified that the shots were fired from a nearby hill. Find clarinex Even though the military has confirmed that indeed there were Border Police armed with high velocity tear gas positioned on that hill, find clarinex the entire investigation into Tristan’s shooting relates instead to the irrelevant conduct of an irrelevant squad of Border Police positioned on the other side of town. To date, find clarinex the Border Police on the hill where the shots were fired have never been questioned. Is there anything we can do to help demand justice for Tristan? We are demanding that the criminal case against the Border Police involved in Tristan’s shooting be re-opened immediately and a meaningful investigation begun. Friends are urged to contact Barbara Lee, find clarinex Tristan’s representative in Congress (202-225-2661) or to picket their local Israeli Consulate, find clarinex ( demanding that Israel take full responsibility for Tristan’s shooting. We also recognize that during the time that we’ve been here in the hospital with Tristan, find clarinex two other activists have died at demonstrations against the Wall. Find clarinex Their names were Basem Abu Rahme and Yousef ‘Akil’ Tsadik Srour. Find clarinex Basem was killed while screaming to soldiers that this was a non-violent demonstration and telling them to stop shooting at a woman protester who’d been injured. Find clarinex Akil died coming to the aid of a sixteen year old boy who’d been shot in the spine. To date, find clarinex Israel has killed 23 people to build their Wall, find clarinex and seriously wounded many more, find clarinex including Ehab Fadel Barghouthi (age 14), find clarinex shot in the head at a demonstration several weeks ago. Putting finishing touches on this document, find clarinex I learn that Ahmad Sliman Salem Dib, find clarinex age 19, find clarinex was shot to death just days ago on the 28th of April, find clarinex at a demonstration against land seizure in Gaza. Demanding Justice for Tristan is also demanding justice for them, find clarinex and recognizing the role of the United States government in war and occupation around the world.  Will Tristan make a full recovery? Do the doctors have any kind of long term projection? There is no long term projection. Find clarinex As long as he’s still doing better, find clarinex no one can tell how far he’ll go. Find clarinex But the fact is, find clarinex you can’t just shoot somebody in the head and then take it back. Find clarinex Dead brain tissue stays dead, find clarinex but the human mind can learn to compensate. The most common metaphor I’ve heard to describe brain injury rehabilitation is this: You’re traveling down the road and the highway is blocked. Find clarinex The question is: can you find a way to get to where you’re going using the back roads? People who are successful at brain injury rehabilitation form new pathways and find them. When do you think he will be ready to come home? This is also the question that Tristan asks all the time. Find clarinex We expect to fly back in to California some time in the summer of 2010. Tristan will move in with his parents and live with them in their small rural town. Find clarinex He will continue his rehabilitation on an out-patient basis from there. Find clarinex We plan to also set up a satellite home for him in the Bay Area and move back and forth. My hope is that friends and family will accept Tristan for his abilities and disabilities, find clarinex and find ways to welcome him back home. For anyone inspired, find clarinex there will be a lot of work to do. We are accepting monetary donations through this website. Find clarinex Also, find clarinex we’re starting a Welcome Tristan listserve for logistical coordination of accessibility projects and bright ideas. Find clarinex To subscribe send a blank email to