Further complicating things was the fact that Zach had also experienced brain stem damage.
His mother, Dana Johnston, remained Zach's biggest advocate as he moved from the trauma unit of Louisiana State University Hospital to an acute care hospital in Shreveport, La. That stop was just the beginning of a winding journey that led Zach to On With Life's Long-Term Skilled Care Program for Youth and Younger Adults in Glenwood, Iowa.
After seeing Zach make small strides forward and then plateau after receiving care at facilities in Houston, New Orleans, Mesa, Ariz., and Bossier, La., Dana began looking for something more. Internet searches for offerings that served young adults with traumatic brain injury turned up some results, but Dana said none of them felt "right."
"I spent many mornings, evenings and free time looking for a place Zach could live longterm," Dana says. While Zach has made progress in the years since the accident, he still cannot walk, talk or feed himself. "The nursing home setting was not for him at all. And some of the places I came across online wouldn't take him because he couldn't use his hands, or because he had a feeding tube, or because he wasn't independent enough."
But Dana knew that something needed to be done. In the nursing home in Bossier, Zach was down to just 96 pounds and she could see in his face that he wasn't happy.
"I went home [from seeing Zach] crying most days," she recalls. "I finally decided we needed to do something."
With the encouragement of her husband, Dwaine, Dana reached out to On With Life and connected with social worker Julie Wells. The two hit it off right away and Dana decided to come to Iowa for a visit.
"As soon as I got there, I knew it was where Zach needed to be," Dana says. "And Julie and the rest of the staff at On With Life did all they could to get us there."
"It was in February or March of 2012 that Dana connected with me and we began to email back and forth," Julie recalls. "Moms and dads of children who have a brain injury will do whatever it takes to get them the care they need. Dana was determined to find the right fit for Zach and we were happy that she chose to bring him to On With Life."
Zach moved in on December 31, 2012.
"We started the New Year with a bang," Dana says with a chuckle. Dana followed Zach to Iowa and lives in Glenwood. She says she knew early on that they had made the right decision in coming to On With Life.
"It's not the huge things I'm looking for," Dana says. "What I've been impressed with is the fact that they are not going to give up on Zach and they are not going to let him give up on himself. He is respected, he has his dignity back and he is happier. Those are the things I'm looking for."
While Zach works with a variety of care providers, he has grown close to his physical therapy assistant Jan Hustak. Dana says Zach's connection with Jan has gone a long way in terms of improving his mood and demeanor -- even if they didn't hit it off right away.
"I could tell at first he wasn't real sure about anyone, including Jan," Dana says. "But about a month after we were here, I was sitting with Zach alone and I asked him, 'Do you like it here?' and he lifted his foot to tell me 'yes.' I then asked him if he felt like he was being treated better here and again he answered that he was. That made me feel really good. He has put his complete trust in them and so have I."
Jan says the team is taking the long view with Zach.
"We know we are probably not going to see overnight success, but that's not going to stop us," she says. "We are all about the long-term. We will continue to work and continue to progress, even if it's just one small step at a time."
The therapy team regularly works with Zach on his flexibility, provides therapy in the pool and is using a technique designed to stretch his muscle fibers and break down scar tissue. Jan says she has been impressed with Zach's commitment.
"When he first moved in, he didn't want anything to do with therapy," Jan says. "But as we've helped him build trust in us he has shown a real willingness to work in therapy. His acceptance and participation has been the key to the gains we have seen."
Among those "gains" are more than 10 pounds. A sign, Dana says, that Zach is comfortable in his new surroundings. "More and more of his personality is coming about each day," she says.
"He has just made so many friends here, especially among the nursing assistants. But they're not the only ones. Everyone here -- from administration down -- is out and about. They are visiting with families, visiting with persons served. It's one big family here."
And Julie says that family wouldn't be the same without Zach... or Dana.
"Dana's spirit, advocacy and faith are unmatched," Julie says. "That is an asset to us. She knows nothing is guaranteed, but she remains faithful and prayerful. That is an inspiration to all of us."