Wednesday, 21 March 2012

The Awakening

That would be a good name for a movie....
After the surgery, I was placed in intensive care.  I was naturally listed as serious but stable until I awoke.
It started in the normal way.  You might even say I had my first case of deje vu as I awoke to find myself looking for Mr. Happy.  Typical male I guess, but to abject dismay and slight anger I found that there was an apparatus attached to it in the form of an ominous tube.  I remember clearly stating that I did not want to awake with one in me; a catheter that is.
 Now naturally the doctors agreed with me but protocol and the fact I may wake up six months from now ensured that the tube was there.
As I tugged at it to get it out, my neighbor, Liz Mackenzie, a nurses aide, came in to check on me in hopes to relay any progress to my very distraught parents as they waited downstairs in the “Death Row” waiting room.
I opened my eyes looked at her and said “Hi neighbor, get this f-ing catheter out of me!”

         She said she would tell the nurse and they would remove it for me.  She left quite pleased with my questionable bed side manners.   Three things were determined in that short encounter.  I was awake and not paralyzed.  I remembered her and damned if my vocabulary wasn’t polished and fully functional.

         The doctors had to throw out their game plan.  My stay in ICU was shortened from 3 to 5 days to overnight.
         I was moved back to my room on December 06.  I awoke to see both my parents standing there waiting for this special moment and of course I would not dismay.

         It is funny how drugs can play on your mind and of course my editing would later be a concern I would have to overcome.  My father stood at the bottom of the bed looking at me stoically while my mom sat by my side holding my hand.  I looked up and said “Hi Dad, I hear ya thought I was gonna die on you last night?”

“Yeah”, he said with a sigh, “You came pretty close”.

“No way” I announced with my chest puffed out.

“What do you mean by that?” Dad inquired.

“I haven’t screwed enough chicks yet!” I said with a wry smile.

With that my mother’s hopes were dashed.  A proud woman of a very strong British, Victorian upbringing, she stood up and stormed out of the room in absolute disgust.

My dad, who looks like Peter Falk, turned and went to catch mom muttering something to the effect, “At least we know he’s normal!”

The new day in my room started like any other.  Nature called and I wanted to go to the washroom.  The nurse handed me a bedpan and pride in my hand I refused, demanding I be allowed to walk to the bathroom.  The nurse said “You can’t, you just had brain surgery.”

I said “Either you help me or I’ll walk myself.”

She said ‘You’ll have to wait until I ask Dr. Cameron”

I said “O.K.”

She left the room and paged Dr. Cameron who in turn told her that if he wants to walk then let him.

The nurse returned and helped me out of the bed.  This was the first awareness that there was a suction apparatus attached to my head.  I held onto the I.V. pole and the suction in the other hand and together we walked to the bathroom.  As the nurse stood there I told her I was O.K. and would like privacy. She left until I pressed the button and was then escorted back to my bed.  There was a mirror in the bathroom and I looked at my bandaged head and puffy face and was not overly moved by the image.  I went back to bed and watched T.V.

It was a new day, a new dawn, of which to now I have had 34 years of bonus life.
I have experienced fatherhood and as I write my 9th and 10th grandchildren are due before Xmas 2012 and I will be a mere 53 years young.
Thanks to the skillful hands of Dr. G. Stuart Cameron of Victoria B.C. Canada for that miracle.

My next insert will be Homeward Bound

Sunday, 18 March 2012

4.5 Hours and I Lived....Sort Of...

With all the tests completed, Dr. Cameron schedules the surgery for December 05.  He had decided the flight to Montreal would kill me and time was of the essence.
I was wheeled into the O.R. where I was hooked up to all the gadgets that would be needed for this delicate operation.
Dr. Cameron explained that I might awake with some speech issues and I said, "O.K."

What he actually meant was that he felt I would awake paralyzed down the right side of the body, be speechless and that my short term memory would be all but gone.
This was the reality my parents had been prepared for including possible death.
All was uncertain until the actual event where the doctors revealed my brain and went to work trying to mend the damaged arteries.
The operation was scheduled to last 4.5 hours.
The night before the male nurse showed up to my room and informed me it was time to be shaved again.
I laughed at the thought there was anymore hair left below the waste.
He said its time to remove all the hair on your head.  I sighed and said "Fly at er".
He did and for the first time I realized how much insulation the hair was.  It was 70 degrees inside and I felt cold.
The first step in the operation after being put under, was to cut the skin around the skull.  It was in the shape of a question mark.  The surgical term was in fact an "Australian Question Mark Incision".
The doctor peals back the skin towards the eye and then he brings out the drill.
A half dozen burr holes are drilled and the saw is passed through one hole through to the other and a cut of the skull is made.  The skull is removed and the surgery is now on in earnest and there is no turning back.

When the doctor opened me up he was surprised to discover an artery ballooned and on the verge of rupture.
There were 2 blood clots the size of a man's thumb.
One of the clots was on the surface of the brain while the other went deep inside.
This now routine operation, if one could refer to any brain operation that way, had become more complicated.
Rather than 4 and a half hours the surgery would slip easily past the 5 hour mark, then the 6th and then the 7th hour and finish at 7 and a half hours point.
My parents obviously knew this meant the doctors had met with complications and the outcome could not be good.
Dr. Mackie, who assisted Dr. Cameron came to the waiting room, looking ashen faced and completely worn out.
He first apologized that Dr. Cameron was not here but an emergency had just arrived and he was back in surgery.
He explained the complications of the aneurysm needing to be clipped.  The two blood clots that were removed and said that he would not know how well the operation went until Kevin awoke.
He also mentioned that I could awake and then regress as the brain may still swell after the surgery and I might even have seizures.
The good news for my parents was that I lived!

December 05, 1977 the day I died....

Yes, all this time I have been blogging from beyond the grave,

I might as well be given the fact that so many choose to ignore simple facts that can not only save a life, but can save you an horrific future where possibly, your own career and dreams never materialize.

I am speaking to mom's, dad's, brother's, sister's, grand parents and even best friends.
My brain injury was not avoidable.  It was a birth defect.  Countless other brain injuries, in fact all traumatic brain injuries (TBI''s) are preventable.

The slightest brain trauma will cause permanent damage!

Oh, I know I will be raked over the coals by the medical community for that statement.
You may even say, "How dare you?"  "I thought this was a blog that promotes hope?"

I do, and you will see, but lets call a spade a spade,  you want to avoid at all costs, a brain injury. The hope in this is that if we can get people becoming proactive in prevention then possibly we can stop having this conversation.

Don't let your kids head a soccer ball.
Don't ride your bike without a helmet.
Don't get behind the wheel after any drink.
Don't let your friend drink and drive.
Don't bully.
Don't fight.
Follow all safety measures at the work site.
Don't skateboard or roller blade without a helmet.
Don't ski or snow board without a helmet.

Your future career may be at stake.

I wanted to be a professional scuba diver.  Due to the brain surgery, where the left side of my skull; was effectively removed, that career choice was dashed along with several other ones.

Due to short term memory deficit, I can't be a cop, a doctor, a lawyer, a judge, and so many other meaningful jobs.

I have been a sawmill worker.
I almost killed a co-worker when we failed to follow safety rules, did not lock out the machine and he went to remove a stick from an in-feed table and whilst he was doing that, I forgot he was there and flipped a log with the pull of a toggle switch.  It almost took off his head.  He heard the sound of the air cylinders firing and pulled back just in time.
I was a first aid attendant for 14 years, however I always feared forgetting one step in the ABC's of first aid that could have ended up killing a patient.  Fortunately for my many patients, I did not skip a step and they all lived.

Each neuron has a pathway.  If that pathway is damaged then the signal has to find an alternative route.  A secondary route that is not as fast as the original.

I failed math 10, three times.  I had the surgery and magically the math skills came back and I went from D to A.
Usually after surgery the opposite happens.
I merely want to emphasize how avoiding any brain trauma is good for you.

What if I have a concussion?  I don't notice any long term disability.  How can you say all brain trauma is permanent?

I like to answer that with a question.  Are you sure?

The damage may in fact, be minuscule.  Your sleep pattern is just slightly altered.  You need a nap in the afternoon which to you is unusual but you blame something else besides the concussion.  You blame stress at work, your finances or your relationship.  You never truly give any credence to the insignificant bump on the noggin you got the month before.

It may alter, ever so slightly, your word finding ability, or your mathematical skills, or more personally your ability to be calm and patient with your friends, co-workers, or even your kids.

It can lead to violence to a friend or spouse, loss of a job, loss of friends and all because you didn't take note of what that rattling of the brain did to you, took no further steps beyond a trip to the emergency department. The emergency department diagnosed you as "concussion" and sent you home with a sheet of paper outlining what to look for in behavior over the next 24 hours and that's it.

You have to be your own best advocate.  It starts with prevention and ends with pro-action.
What is pro-action?

If I could I would have a test designed that you could perform on yourself that measures your brain activity.  You would save that score for later use.

After a brain trauma you take the test again and measure it against the previous one and see if your score is lower.

Since we don't have one it is important to pay attention to behaviors and skills before the injury and compare it to those after.

At the time of the injury have a loved one take note of any alterations to brain functioning of you and after a short while seek medical attention if you feel things have changed.
Write down the things you notice.  Keep a journal so that you are well informed when you see your G.P.  He/She might be able to re-direct you to a specialist who can help mitigate the concerns you have noted.

It unfortunately starts with you and ends with you.  The better prepared you are the better you will have of navigating this bee's hive known as TBI.

Avoiding or preventing a brain injury is the best place to start.

Wednesday, 14 March 2012

The Wait.

The final test was to be performed in Vancouver General Hospital.  The newest piece of technology had arrived some 6 months before and was what we now commonly refer to as the C.A.T. scan.  It was first generation with relative grainy pictures that scanned my brain in slivers revealing any anomaly that may present itself to the trained radiologist.
I was hooked up to yet another I.V. while contrast dye coursed through my arteries to make them more clear on the scan.
After the test was completed, my parents drove me back to Victoria, Royal Jubilee hospital, a ferry ride away.
I had a slight reaction to the contrast dye and my joints began to ache,  I am not sure if this was a drug reaction or simply anxiety and frustration from 2 weeks of being poked and prodded.  My left arm looked like the arm of an addicted I.V. user, with tracks from where they had either taken blood from or had added I.V.'s too.
All I know was I was in discomfort.  As a result of this Dr. Cameron had advised the staff to keep me comfortable so that my blood pressure did not spike. 
I was given a sedative, however the pain did not abate to a shot of Demerol was administered.
Now the cocktail seemed to have worked too well. Back then, you could smoke in your room.  Due to the drugs, the nurses took mine away from me.
I went to sleep but suddenly I awoke in a panic.  I had hallucinated that I had dropped my lit smoke.  The nurse hearing the commotion came into the room and asked me what I was doing?  I explained and she said she had taken them away from me earlier.
I went back to sleep but again awoke when I thought I had fallen out of the bed.  I opened my eyes slowly and saw that the side rail of the bed was indeed up.  Logic then kicked in and I decided that maybe I fell out of the other side of the bed.
Rolling over I saw that the side rail was also up.  It was at this point that I decided, to stay awake and stare at the ceiling until I came down from this drug cocktail high that I was on.

With the tests all but over, it was now up to Dr. Cameron to decide when and where the operation would take place.  His concern was the technology in Victoria was not as advanced as it was back east in Toronto or Montreal and he felt I would have a greater outcome going there.
He then determined that chances were, I would not survive the flight as it may have an adverse affect on my blood pressure and determined that December 05, 1977 would be the day he would personally try to save my life.

Tuesday, 13 March 2012

You're Gonna Shave My What?

As pride goes, in 1977, long hair was in, I was 18 and I had absolutely no idea the condition I was in.  The ward was 4 West at the Royal Jubilee hospital in Victoria, B.C.
The medical staff who worked that floor referred to it in private as "Death Row".  Those who entered rarely lived past a few days and those lucky to escape the grips of the reaper, left half the person they once were.
Most patients arrived with acute trauma to their head which resulted from a motor vehicle accident of some kind.
It was all the doctors could do to simply try to put "humpty" back together again.  Unfortunately it usually meant that the person may have lived but crucial areas of the brain were beyond repair.

In my case the nurses wondered why I was there.  Few understood that an eighteen year old could have suffered a stroke.  This was reserved for the aged and no so for the young.
Since I presented with a normal outward appearance free from the trauma found in the motor vehicle accident victims, they often asked me, "What is a young man like you doing here?"
It was only when they read my charts did they understand and in many aspects I think that they had empathy for me, because they new how the odds were stacked so heavily against me.

I stated earlier that I was a dead man walking, however the medical terms would have most likely said I was either serious and in stable condition or critical but in stable condition.

I was informed that I was about to undergo a specialized test.  It was called an angiogram.  It is a simple process where a highly trained doctor threads a small catheter up through a small incision in the groin piercing the femoral artery and threads this tube up the chest through the heart into the carotid artery and into the brain.

The test would commence in the morning.  That night a male nurse came into the room and said, "It's time for your shave."
I thought to myself, "Lets see, I've been shaving for 2 years now and I cut myself both times."
I looked at the nurse and said,"I don't think I need a shave, but thanks just the same."
He replied, "It's not the face I will be shaving."
I said, "You're gonna shave my WHAT?"

He explained that for the test all hair from my knees to my belly button must be shaved as to guard against infection.
Now, I don't know about you but I am in my prime, I get an erection when the wind blows and some guy is going to be shaving me, down there.  It took all my strength to and all my prayers to save me from that embarrassment.

The next day, I was wheeled into the operating room.  Little did I know the entire medical staff was on standby for this little innocuous test.
When they thread this catheter up into the brain, there is only one reason for it and that is to inject a dye into your arteries and then take a picture of them.

This was the test from hell!  It hurt worse than the actual aneurysm rupturing.

First the doctor targets an artery that feeds the frontal lobes of the brain.  He counts back from 3 and then BOOM!; He injects this vile drug

The pain is instant and then in a heartbeat it is gone.  It is like someone lifting your skull off and pouring scalding water onto the brain.

Now the frontal lobe along with the parietal regions of the brain have fewer arteries than that of the occipital or rear part of the brain.  This is where the bulk of the brain is and this is the test he leaves for last.
My eyes are already watering from the first 3 regions being tested but he tells me I have to be really still for the last test or he will have to take a retake.

Well suffice to say I did not budge, in fact I am certain that my fingerprints are firmly embedded in that metal operating table.
The doctors were on standby in case the dye hit the brain through an open artery or if the process caused the weakened arteries rupture. 
Neither materialized and I was sent back to my room. bald in all the wrong places and wondering when it would all end.

Saturday, 10 March 2012

Scary Stats!

A head injury is any shaking or trauma to the region of the neck and or  head.  Whiplash means your brain has been violently tossed back and forth in your head.  (Shaken Baby Syndrome is similar in nature) The inside of the skull is rough and porous.  Arteries do rupture.  When they rupture oxygen to the part of the brain the artery once fed, stops.  That part of the brain can be affected after 4 short minutes.  It can even die completely.  Doctors now believe that brain injury may not show up on MRI tests as they can only scan down to millimeters and brain damage may occur at the molecular level.  Assaults, heading a soccer ball, a broken nose and a skull fracture are vectors for brain injury.  The present rule of thumb many hospitals remains the same, unless it is absolutely obvious then we don’t consider nor do we have a classification for brain injury.  In B.C., when you arrive at a hospital for a broken nose or a skull fracture, it is classified as that, a broken nose and or a skull fracture.
         No one has put 2 and 2 together to get 5 and that is the problem  They know 2 and 2 is 4 and so that is all they go on.  Whiplash is a trauma to the neck and therefore that’s where the treatment is focused on.  They cannot work out of the box and ask the basic question that if the soft tissue of the neck can be damaged then wouldn’t it go to say that the soft tissue in the skull called, for the lack of a better word, the brain, also end up injured?  Just this year a man who was beaten severely about the head entered a Vancouver Hospital, was thought to be drunk and released.  His wife found him wondering around the streets and took him to the hospital where he was then admitted and part of his brain was removed. 

Here are some basic statistics that might floor you. 

Courtesy of  Brain Injury Associations of B.C.

Brain Injury is the #1 killer and disabler of people under 45.
14,000 British Columbians acquire new Brain Injuries each year.
160,000 British Columbians live with the devastating impacts of Brain Injuries at any time.
Motor vehicle accidents account for the overwhelming majority of deaths and disability by unintentional injury.
Research indicates that as many as 9 out of 10 unintentional injuries can be prevented.
The cost to society is immense. Brain Injury alone costs Canadians more than $1 billion per year.

Signs of a Brain Injury

Signs And Symptoms of Brain Injury
The original title was going to say “mild brain injury,” however I think the medical staff should stop classifying brain injuries that way.  It is abominable that one would relate to any trauma to the most critical organ of the body as mild.  It is misleading to say the least.  A mild brain injury can still leave lasting, permanent impairments to the patient.  Now I’m sure the editor will have fun with the plural found in “impairments” but I assure you that as complex as the brain is the likelihood of escaping with only one disability is as close to impossible as one gets.  I do not want to frighten you but it is imperative that you the reader appreciate the scope of the serious nature of brain injury.  There is no such thing as minor.  You may deny and hope for the best but be prepared for a life of hardship.  You may want to sweep the mild almost laughable short term memory damage your loved one now displays under the rug but believe you me, it will come back to haunt him or her and you for years to come. 
The argument will be in a statement of “Well, we all forget from time to time, so what is the big deal?” 
Try living with a mild memory disability for a moment.  The frequency that a non brain injured person will forget is for the sake of argument, 1 out of 10, while a brain injured is 4 out of 10.  That means that you lose your wallet one time while a brain injured loses it 4 times.  Now these numbers are arbitrary and I only want to demonstrate to the non brain injured what it is like to live for a moment in my broken brain. The frequency to my forgetting is 3 or 4 times more than what it is for you.  I have lost 7 wallets so far.  “So what.” you might say.  Well that is seven driver’s licenses at $35.00, cancellation of credit cards, of re-applying for social insurance card and birth certificates so that I can get my ID back.  That is several hundred dollars not to mention any money left inside the wallet.  It is leaving the house to mail a letter and getting half way to the mail box and realizing that the briefcase is at home and turning back and picking it up.  I then get to the mailbox and realize that the letter was beside the briefcase.  It is having your wife say please bring in the stroller from the car as you are walking out of the door and getting into the car and driving away because between the door and the car you forgot.

It is being chastised by co-workers and bosses because you look and sound normal therefore you are faking it and are simply incompetent or lazy when you fail to remember to complete tasks.  Then this “mild” memory affliction weaves its way into your daily routine.  Your wife gets frustrated because you remember some things and not others.  Are you faking it she asks the doctor?  Why is it he remembers a news event but can’t turn off the element?  Your children take advantage of your memory loss like all good survivors do and when you ground them for something they know by the second day you will have forgotten it.  What about that appointment?  Returning an important message?  The self confidence of the brain injured takes a nose dive as he questions his every move.  Did I say or do that and immediately when you are asked did you lock the door or turn off the element you can’t recall.  Unscrupulous people take advantage of this and quite often to avoid conflict the brain injured give in to an argument where they were in fact correct but due to circumstance could not find the words to argue the point effectively. Now we have only scraped the top off this iceberg because the results of this continued memory problem incites a whole new process called frustration, anger, misunderstanding that often leads to divorce. 
Remember, injury survivors enjoy a 90% divorce rate.

So now that I have somewhat enlightened you let us explore the many signs and symptoms.

Depending upon whether you are a school age person or employed one of the potential signs to come out of brain injury is:.

1)      Reduced Attention and Concentration

Employ your teacher or co-worker to keep tabs on the brain injured performance.  If grades decline or the person is being reprimanded often at work this could indicate trauma to the brain.

2)      Memory Loss

This can affect long term memory however in most cases some level of short term memory loss occurs.  This is usually permanent as short term memory is located in one region of the brain and long term memory is dispersed all over the brain.  Some people with severe cases cannot remember anything at all about the “NOW” but can tell you who won the Super Bowl 10 years ago.  When you talk to them and then leave the room and return they can’t recall that you were just there with them.

3)      Emotional and Personality changes

Easily frustrated.
Easily angered.
Overreaction to events.
Decreased emotional responsiveness.

That is a big list but it can be displayed in many aspects.  Everything that will be listed here may not reveal itself in the patient.  I personally relate to three of the above six listed.  I no longer assemble items or repair things or help people move because my tolerance is very limited.  To avoid frustration and not because I am looking for an easy way out I avoid things that may cause frustration.  When I get frustrated, I get angry and in fact embarrassingly, I used to get very angry.  I punched holes into walls, my vocabulary was quite colorful.  I  took an anger management course and delved into my brain injury in a way I had never done previously.  Now that I can identify some of the triggers that cause frustration I can reduce the level of outbursts. My loving wife has also had to learn on the fly how to monitor my behavior and identify those moments where I need to take a break so that I avoid those frustrations that can escalate.  Her role is critical to my success.  By not placing demands on me and identifying those things that can cause me frustration and communicating to me that it’s time to walk away, the incidents are few and far between.  It is a symbiotic relationship.  Yes, I can manage on my own but a relationship, and more so a successful relationship is dependant on both parties working in unison.  It is a new dance that we both must participate in and in this sense she becomes the lead and I relinquish that role.

4)      Cognitive Changes

Reduced reasoning and problem solving
Difficulty following directions
Misunderstanding what is said by others
Difficulty expressing thoughts verbally

In this I see all four in myself to one degree or another.  My problem solving is quite good and in fact math comes to me easily.  Prior to surgery I failed math 10, three times.  I passed Math 11 with an A.  Difficulty with following orders for me is directly related to the memory recall set back.  I can follow directions if they are not given too quickly.  Give the brain injured written instructions if you do not want them to forget one of the items.  The more stressed they are in remembering the less they recall.  I take things quite literally and sometimes misinterpret what the individual is conveying to me.  I may even get offended by what they have said.  The old statement, “I forget too,” is a common statement meant to make me feel better and offered by caring people.  It offends me because I have a higher frequency of absent mindedness that the other person can’t begin to comprehend.  I ramble on and on and on and on because my thoughts are scrambled and I’m not sure until the person I’m speaking with has been bored to death by my repetitive nature as to whether they got the point or not.

5)      Social Behavioral Changes

Impulsive or inappropriate social behavior
Reduced Judgement
Decreased insight into self or others
Difficulty establishing and maintaining relationships
Difficulty following through with responsibilities at work or home.
            Inappropriate behavior can manifest itself in many forms.  In Golden Girls, Stella the older mother often spoke her mind.  Children, also find this to be quite a task and may state out loud, why is that lady so fat?  This is a mild example but it can take more serious formats such as exposing oneself in public.  Naturally we are more concerned with moderate alterations.  If more severe cases are present, you already know a brain injury exists.  Reduced judgement can come in different forms.  Poor choices of new friends who take advantage of the survivor are quite common.  I am taken advantage by others because I cannot argue effectively even if I know I am right.  All a person has to say is don’t you remember, you said this?  Now I am lost and must relinquish my position because I honestly don’t remember if I did say it or not.  I have a very patient wife and therefore my relationship is still in tact for 12 years, however that bucks the national trend for brain injured people.  The normal path is divorce, drug and alcohol abuse, crime and prison for the male population.  I have also dwelled on the final topic of not following through on responsibilities.  My brain won’t allow me to complete tasks based upon distractions and memory.  If I am doing a task and the phone rings, the other task may be stopped briefly or completely abandoned as a result of forgetting that it even existed.
Obsessing is a talent I have mastered well.  I get stuck on a subject and can’t shake it for days, weeks and even months at a time.  Some people actually get so stuck that when they are informed that they are going to the Doctor at 3:00 that afternoon, will get dressed at 9:00 AM and sit in the car awaiting the time when they must leave even if it is six hours later.  My children dread the fact that we are going to discuss a subject because I go on and on and on.  Sometimes they feed into this just to get my goat.  I have gone to counselors and have managed to get them so far off track they forget where they were.  I’m not sure that is obsession but it comes out of a fear of forgetting what I am saying and if the counselor says something or in a conversation I remember another important piece of information, I simply blurt it out.  It takes a talented person to keep me on task.

6)      Physical Complaints

Head Aches
Dizziness balance problems/vertigo
Muscle weakness
Numbness and tingling
Fatigue or difficulty sleeping
Blurred vision
Ringing in ears.

If you suffer from a head ache that is the most painful you have ever experienced, then go straight to the hospital, do not pass go do not collect 200 dollars.  This is a tell tale sign of a stroke or brain aneurysm and believe me even if it proves to be anything but that you’ll be better off than had you not gone at all.  Fifty percent of those who have an aneurysm in the brain drop dead on the spot.  In my case nausea came with the pain in the head.  I never felt weakness, tingling or numbness but to this date I tire easily.  I write about one page of this book and it takes about 1 to 2 hours.  It virtually wipes me out mentally and must retire for the night. I have erratic sleep habits.  My most common routine is to go to bed for 2 am and wake up at 8 or 9 and then have a nap at 4 P.M. and stay awake until 2.  Sometimes I get up at 3 and 4 am but can relate that to too much caffeine.  I do not suffer from blurred vision or ringing in the ears unless my wife screams at me and or whollops me with a frying pan when I act up.  O.K. a little levity, my wife is not an ogre.  My point in this exercise is to have you realize that you may suffer from one item or another or none in one category but many in another.  The objective of this exercise is to get you looking for signs of a potential brain injury and if by chance you are led to believe your loved one has suffered from one, you can take the next step of getting referred to the right specialist.  What was one of my first brushes with the rupturing of an artery occurred in Vanderhoof that June day of 1977.  In that I did experience nausea, dizziness, vertigo and muscle weakness.  It was one of those tell tale signs that was grossly overlooked by the medical community on 2 separate occasions.  The other happened on Halloween night.  Although this second event eventually led to the correct diagnosis, my G.P. was willing to pass off these signs and symptoms as that of a migraine.  I have repeated these to moments here in hopes to enlighten you on the importance of your roll as a caregiver when you the symptoms you witness are suspect.  Insist on a second opinion, insist on an MRI or CAT brain scan and don’t stop until you are shown convincing physical proof that rules out a brain injury.  Do not settle for an opinion based of an educated guess.

7)      Denial or Lack of awareness of deficits

This was and probably still is me as I slowly open my eyes to this world of brain injury.  It wasn’t until I began writing this book that I actually examined my poor behavior as a teen and managed to tie it directly to my memory deficit.  It wasn’t until 1995 that I even believed that there was anything wrong with me beyond a mild case of forget-me-not.  It has been a frightening and sometimes painful ordeal to finally look into the mirror and see a broken brain, a broken soul whose life has been tarnished with one failed opportunity after another.  The only thing that keeps me going is my personal determination to overcome.  It helps to be quite forgetful because you end up forgetting what you were mad at yourself for and off you go again determined to succeed.

8)      Difficulty on the Job or at school

This is crucial to your future.  Your boss or your teaching staff should be made aware of the brain injury and potential side affects.  I went to work in a saw mill.  I did not inform my bosses of any deficits because I didn’t have any.  I was cured back in 1977.  I almost killed a co-worker one day and that was directly related to a poor memory that I didn’t have.  I’ll elaborate on that later on, but for now it is important for you to realize that you may save your loved one the loss of job or a child from failing school and slipping down the slope of no return.  If the proper authorities are made aware of the situation they may be able to accommodate the worker or student by reassigning them to light duty and for school, tutoring may be the course of action.
            There will be many challenges, prejudices and misunderstandings by everyone you come in contact with.  Many will try to downplay the severity of the injury.  I had a psychologist state she would not write a letter supporting my application for disability status because she has seen worse cases.  I know how fortunate I am and that there are worse cases, however that does not take away from the fact that I am permanently brain injured and my performance in a work environment is jeopardized by those deficits.  I know, I experienced the anger from bosses when I forgot to push a button and caused downtime.  In one case I almost killed a co-worker because I forgot he was working near my machine and I flipped an 800 lb log.  He felt the wind of that log as it passed within inches of his head.   My goal for disability status was not to avoid work and ride welfare but to re-educate myself into a role that would suit my specific needs.  The Doctor thought differently though and that could have spelt disaster for my employer or co-worker who would have been unaware of my deficit.  Could you imagine leaving me in charge of locking up or shutting off stoves, heaters and the like?  As an employer you could stand to return to charred ruins because one step in the shut down process was overlooked by someone who looked “normal” but was hiding a memory deficit.

There isn’t even a listing referring to the eating disorders I mentioned earlier where one forgets to eat or forgets they have just eaten and eat again.  Oh yes, this is a memory issue isn’t it?  It could be a complication of the receptor responsible for informing us that we are full or we are hungry.  I cannot cover every single item that may arise from a brain injury but for every possible brain function there can be a complication of that function if the part of the brain responsible for the action is damaged.  This then encompasses every known physical and emotional dilemma discovered by mankind.  Every neurosis, every phobia, every emotional issue can manifest itself in the brain injury.  Of course not all will and some are more manageable that others but one should be cognizant of the likelihood that you will be visited by more than one issue with a brain injured person.

Here comes the tests!

It started inconspicuously by drawing some blood, and then some more blood and even more blood, it seems everyone and their dog wanted some.  I was becoming anemic with every request.  A  psychologist even had her chance to prick and prod me in the mental arena.  First another  electroencephalogram (EEG) was performed.
The psychologist performed a simple test of showing me everyday items and asking me to identify them by name and explain what they were used for.
I looked at the basket of innate objects and said this will be easy.  First she pulled out a black object used even by me and I said, "I know that!" "It's a, a, um.......It's a, I dunno."
She asks me, "What is it used for?"
I reply, "It's  used for, um, a, I'm not sure"
The item in question was a comb.
I also got stuck on paperclip. I could use the item but had no way of either finding the word comb nor what words to begin explaining it's confounded use.
It was as obvious to me as the psychologist that my recall ability was not working and later I would realize that my short term memory had also taken a direct hit.
A week or so before I checked into the hospital I remember going for lunch with my grandmother to a local restaurant and I ordered a cheeseburger.  I hate tomatoes and asked the waitress to remove the, and I couldn't remember the name tomato, so I said its round and it grows in the garden.  She asked, "Lettuce?"
I said, "No."
She asked, "Pickle?"
I replied, "No."
"Onion?" she prodded.
"No." I said again.
She then asked, "Tomato" 
I said. "That's it!
I never knew there were so many round things on a friggin burger!
It would have been easier to have it served and I pull the round red thing out before I ate it.
The short term memory also explained the misconception that I was lazy and only performing half the tasks.
I don't know how many times my mom asked me to take the garbage out and I would agree and before I took it out I would get distracted by something as mundane as a call of nature.  After exiting the bathroom, the thought of taking the garbage out had vanished.  I don't know how many times that happened but it would frustrate me as much as it did my mom for totally different reasons.
She thought I was lazy and I thought my memory issue lay in the fact that I had recently discovered marijuana.  I was not about to raise the concern with my parents so both of us had it wrong and it almost cost me my life.

Friday, 9 March 2012

Dad's Boot and My Ass

On Monday my condition had not improved and the head ache persisted.  My dad, at my mother's cajoling insisted I go the the emergency department.  At 6 P.M., we went to the Emergency of our local hospital and I was examined my an Emergency Department doctor who in consultation with my G.P. determined that all I had was a migraine and sent me home with a handful of 292 pain pills.
Over the next few days my mom still seeing little improvements in my overall demeanor phoned my G.P. and he was less than helpful.  His position was, "You get migraines therefore he should get them too. Your son is overacting, tell him to get on with it."
On Friday, my mom took me to his office.  He, fortunately was not the attending doctor, instead, Dr. Mackie was in his place.  My mom explained the car accident, the missed broken arm, and queried the doctor as to whether or not they might have missed a brain injury.
Dr. Mackie concurred and ordered up an X-Ray, a Brain Scan and an EEG.  He also made an appointment with a Neurologist.
Over the next two weeks, I went for the EEG, then the X-Ray, then the old fashioned brain scan.  I drank a barium mixture and they placed this large disk against the side of my head and took pictures of the arteries that  glowed due to the barium coursing through them.  A CAT  Scan was not available in Victoria, B.C. in 1977.  The first generation of it was available in Vancouver, B.C. a ferry ride away.
I went to the Neurologist with my father on a Wednesday.  He did his usual, follow the pen routine, examined the front of my brain by looking in my eyes with the scope and concluded that it was a migraine.  He closed the visit with, "If anything shows up on the tests your doctor ordered, I'll eat my shirt."

Let us sum it up for you.  I have had teachers say I was lazy, lacked concentration, was incorrigible, had my Doctor, who delivered me no less, treat my fainting with blood tonic, diagnose my head ache over the phone no less, and had a neurologist say it was just a migraine.
My dad, was from the old school where you did not question the opinion of the teachers and treated Doctors like they were Gods.
To say he was fit to be tied, given the fact I had been behaving this way for 4 years, would be an understatement.
In fact I take my hat off to him because with all that going against me he still was willing to await the final judgement.
The only thing between his boot and my ass was the results of those infamous tests.
On November 21, 1977, I sat down to dinner with my mom and dad when the phone rang.  Being a teenager, I jumped up to answer it. It was the Neurologist.  He asked me what I was doing and I said, "We are just sitting down to dinner."
He then said, "I am about to eat my shirt." 
I inquired, "Why?"
He responded in a matter of fact tone of voice, "We have found some inflammation on your brain and want you to check into the hospital first thing in the morning."
I responded, "O.K., would you like to speak with my mom?"
The doctor said "Yes."
I handed the phone to my mom.
I had no idea that I was a dead man walking.  In fact I didn't care.  I felt vindicated!
I figured a needle would fix me.
What I was not privy to was the dire situation I was actually in.
My mother was informed by the neurologist, that I had an aneurysm rupture in my head.  That I was to be kept calm because a spike in blood pressure could kill me.
He informed her that I had at the outside 6 weeks to live.  It depended where the aneurysms were, how deep in the brain they were, whether they were accessible and if there were more on the verge of rupturing.
Fifty percent of those who suffer a brain aneurysm, die on the spot.  The remainder range from comatose, paralyzed, to high functioning brain injured.
The race was now on.  The next couple of weeks would determine my fate and all of it fell into the hand of Dr. S. Cameron, Neurosurgeon.

Thursday, 8 March 2012

Trick Or Treat

I earned a free ticket to the College Dance via my friend Ramin, who happened to be the organizer of the event.  He picked me up along with some friends and we went to the hall and set up the tables befpre the dance started.
I had a total of $5.00 on me.  Beer was $1.00 each.  Here we go again with my favorite subject, Math.
Today that sum might get you one beer but back then I was poised to get 5.  Has anyone called Mensa yet?  I'm bordering on genius.
When the dance commenced I decided to ask a girl if she would be interested in a dance and she said yes.
While dancing, I lost my balance and fell over.  She thought I was inebriated and walked off the floor.  Embarrassed and feeling disoriented, I staggered to the bathroom and splashed copius amounts on my face. 
I simply felt like I was drunk but had to that point of the evening had only consumed 2 of my allotted beer.
My face was flushed and yet I could not explain this loss on equilibrium.  By the nights end I was feeling like someone who had consumed well over the limit of no return and would be snuggling up to the porcelain throne at any given moment.
My friend asked who would like to be dropped off first and I replied "Me".
I was dropped off and remember that with each step I took the house oscillated as if my eyes were on pivots.  I made my way to the bathroom, where I again splashed cold refreshing water on my burning face. 
A headache had begun some time before the end of the dance and I decided that six 222's would do the trick to thwart the onslaught of pain from what was becoming an all out assault on my pain tolerance.
I climbed into bed thinking that I would fall asleep and all would be right as reign come the morning.
As I tried to get to sleep, I found the coolness of the pillow quite comforting all the while the ache in my head increased.
I tossed the pillow from one side to another, switching from one pillow to the next, one side to the other to no avail.
Finally, the pain inside my head won out and I began to cry.

They describe the rupturing of a brain aneurysm as the greatest pain you will ever know.  I would say they were being quite conservative with their statement.
 If someone could hit your big toe with a ball peen hammer, over and over, initially the first strike is the worse and after a while the pain subsides to a dull roar. 
With the brain aneurysm, the pain increases and stays at full volume for several hours. 
As you may recall, I walked in stocking feet on a gravel road wit a broken foot, walked for 10 days on crutches with my left wrist broken, none of which minutely compared to the excruciating pain I was beginning to endure.
It became so intense, I began to vomit.  My mom at my side cooling my forehead with a damp face cloth.
I would drift in and out of consciousness and catapult up and over to the side of the bed where the bucket lay with drive heaves as I had sometime earlier already emptied my stomach's contents. The pain seemed to start at the back of the skull and charge forward to my left eyeball where it felt my throbbing eye would explode from out of its socket.  This continued for several hours until sometime in the early hours exhaustion won out and I finally slept.
Getting up later that Sunday morning, I recall steadying myself with the use of the hallway walls and literally staggering into the kitchen.  My mom noticed that my speech was altered  along with my balance and decided that if there was no improvement by Monday, she would send me to the doctor.
My father felt it was just a hang over and that I would be fine in another day,
My behavior of the past few years had not garnered many votes of support from either my teachers nor of that of my parents and soon my credibility would be tested again, where my very life hung in the balance.
Thank God for a mother's instinct and that of an up and coming doctor.
So Halloween, is indelibly marked on my soul, the treat was an aneurysm and now the trick was how to survive from one.

Wednesday, 7 March 2012

Hope Restored

On August 15, I made my way by bus to the local hospital emergency ward, to have my swollen right knee examined as well as have the cast on my foot re-enforced.  Seems that from time to time I would fall due to how I had to hold my left crutch with my sprained wrist.
Dr. William Mackie, was the attending emergency doctor that would examine me.  Little did I know that he was fresh out of Med School and was in the process of taking over my retiring General Practitioner's business.
Dr, Mackie first attended to my swollen knee explaining that it would have to be aspirated (have the fluid removed) by way of a very large needle.  This was done. 
I then complained about my wrist and showed him how I could lower the wrist but it hurt like hell to raise it up again. 
He asked me if it had been X-rayed to which I replied in the "I dunno" category.
He then send me to radiology for the usual picture.
I returned to the emergency with the X-Ray in hand.  He looked at it and said "Its broken."  "We will need to put it into a cast.
Picture this, a broken right leg and a broken left wrist.  Now envision yourself being 18 and needing a bath.
Things have gone from Bad to worse in a matter of seconds.
Well at least I had some hope restored by mere fact that this doctor had found something that should not have been missed in the first place. 
The remainder of the summer went off without a hitch and I got the casts off in late September.
I enrolled in the local college to complete my grade 12 commencing in January.  All I had to do now was wait for that date to come to fruition. 
God has a sense of humor and decided to let me know in no uncertain terms, who was in charge and he would pick the most appropriate day in which to remind me of his control.
Trick or Treat!

A Missed Opportunity

Well I ended my last blog with "Car Accidents May Cause Brain Injury."  The truth be known, in my case the reverse should have happened to me.  The brain injury should have presented itself had the doctors of the hospital, been performing their duties properly.  How could they take a person with obvious head trauma, who was incoherent, unconscious no less, had a cut on his chin and throat, a broken leg, a girlfriend with a skull fracture, not be scanned for possible brain injury?
If you think you are baffled, where does that leave me?
Later in my life I would be trained as a first aid attendant, and we had to assume the worse case scenario in cases like this.  Prepare for the worse until you can physically rule that out.
In my case I assumed, I had been scanned from stem to stern.  They found my broken right heal bone so one would assume that was all that they found.
I did complain about my left wrist being sore while using the wheel chair but was informed that it in fact was sprained and the doctor slapped a tensor bandage on it and 5 days later I was shown the door.
I walked on my crutches with some consternation as my wrist throbbed when I held the crutch in the proper form and was forced to adjust my handhold so that the part between my thumb and my index finger held onto the crutch.
I flew the 500 miles back to the loving arms of my less that impressed parent's arms.
The accident occurred on August 05, 1977 and like I said, I am great at math and I got home on August the 10th.  Did you know a computer cones with a built in calculator?
My next special day happens on the 15th of August which as you might have guessed it, is five days from the 10th.  Mensa, here I come!  Besides Mensa, the fact that my brain injury went undetected, would conclude this blog by summing it up as a missed opportunity.


The picture I have just shared is not a joke.  It happened to me.  I was driving my girlfriend down a dusty logging road. on our way to a party.  I was sober.  We came upon a lumbering logging truck, the dust billowing out from behind.  Impatient, I decided to pass this truck.  I accelerated to 80 miles per hour when all of a sudden the lights went out!  Pitch black in the middle of the day.  When the lights came back on, I had not only time traveled 6 hours into the future but I had also been beamed up from my car and awoke in an alien operating room where I was being, you guessed it, probed.
O.K., so an alien ship did not beam me up.  I apparently was passing this logging truck and hit a pick-up truck head-on that was coming from the opposite direction.  The force of the collision was so powerful that the hood was sheared off and tossed like a piece of crumpled  paper into the ditch.  The floor boards punched up and back towards the rear of the car embedding the heals if my shoes in them.  The front end of the car crumpled like an accordion and the first 4 feet of  engine space was now flush with the firewall.  The dashboard rocketed up toward the ceiling while the roof descended to meet the dash.  The steering wheel shot out and into the seat while I was pushed like a rag doll towards the driver side door that now had been pushed outwards and down into the dirt of the road.
To think all that I am writing, this little paragraph took all of about 1 minute to write.
All that damage took 1/10th of one second to complete.
Apparently, I wiggled out of my shoes, leaving them still embedded in the floor boards, climbed out of the car and grabbed my girlfriend, and began to walk away.  The logging truck driver became the transporter, as he had determined that we were in the worse shape and drove us to the Vanderhoof hospital.  Several hours later I awoke, in bed, naked and thinking to myself, wow, what a party!
It was at that moment, I felt a hand upon my right knee, that I realized that not only was this a great party but guess what? I'm getting lucky too!
I opened my eyes and followed my body down towards my right knee.  As my knee came into focus, I realized that the hand upon it was that of a guy!  The cheeks of my butt tightened up so tightly you could have cracked a walnut between them.  I then announced quite abruptly, WTF, and followed that with the wonderful term of OMG to which a doctor behind me replied, "It's a little too late for God, Kevin.
It was then I realized the hand upon my knee was that of a doctor and he was re-suturing my damaged knee.
I then asked, "Who died?"
The doctor responded, "No one."
My girlfriend had a hairline fracture of the skull, the driver of the truck walked away and his girlfriend had a broken nose.

NOTE TO SELF:  Car Accidents may cause brain injury.

Tuesday, 6 March 2012

More to come

Now That's Gotta Hurt!

When it all began.

Let's see I'm brain injured.  My short term memory is so bad I can honestly tell you that for the past 34 years I have been practicing "Alzheimer's"  and you want moi to tell you how it all began?
I learned post brain surgery, that in fact the aneurysms, a vein and artery malformation located in my left temporal region, had been leaking for up to 4 years, explaining the two old blood clots discovered during said operation.  Now, math not being my forte, suggests the whole thing started when I was 14.
Thank god for calculators!
How? One may ask can I make light of what truly is a nightmare.  Well it is my belief that humor, the ability to laugh at oneself is better than building up an anxiety that you have little or no control of. I recommend that both the caregiver and survivor try whenever possible, to laugh because there is not much compassion in the world when it comes to Brain Injury.  There is an ignorance, in fact, to brain injury.
When you break an arm or leg, one see's your limitations.  Six weeks later the casts come off and within a short time you go right back to what you are doing.
With a brain injury, once the hair grows back, the average person thinks, somehow magically, you are cured.
They do not understand that the journey back will be a very long time if ever, to the level that the person was prior to the injury.
The average person loses patience, accuses the person of faking it, and has no concept what it is like to have lost ones ability to find words, to remember things, to speak coherently.  My first new medical term after the  injury was "Malingerer". 
Physically I was a 6'3" young man who would be asked to perform 3 tasks by the employer.  I would complete 2 and completely forget the third.  I was in fact considered by some to be lazy.
So in 1973 my world began to spiral downward.  My concentration diminished.  My teachers called me lazy.  My grades plummeted and by grade 9 I was kicked out of junior high school and sent to private school.  My grades continued their meteoric decline until they crashed and burned in Grade 11 and I quit school.
Hindsight being 20/20, the blood clots building up in my brain would have explained a lot to both myself and my parents had there been even a snippet  that something was awry up inside my head.
I had only noticed, that when I stood up from a couch, that on a regular occasion, I would faint.  My doctor diagnosed it as poor iron blood and recommended cod liver oil.  The one and only chance to actually test me had slipped by and I was now a ticking time bomb just waiting for when the big event would take place.

All about me

I'm 52, a survivor of several brain aneurysms that ruptured over a 4 year period from age 14 to 18.
This is my story of those events that brought me to writing about my challenges, my successes in hopes that I may impart some hope to those presently living with a brain injury.  It is also a guide for those caring for a brain injured love one.
Some times my words will seem harsh and even insensitive.  Please understand my hope for you is acceptance of the new reality that comes with the most insidious disability out there.  It is for the most part hidden, misunderstood, difficult to rehabilitate from, leaves a wake of family destruction, broken friendships, and last but not least an injury that is permanent. 
I know these words may cut to the bone, however, if one is to succeed and reach the maximum level of rehabilitation, one must throw away a false sense of hope and replace it with a more down to earth, realistic expectation of what one can expect from your Brain Injured loved one.  If your loved one is like me, high functioning brain injured, the fact still remains, he or she is still permanently brain injured and is prone to have limitations.

My doctor did not pull any punches when I was first diagnosed in 1977.  He said the chances of surviving were slim to none.  Then he said chances were that if I survived the surgery. I would be paralyzed, speechless and have little or no memory.
Now that may seem inconsiderate this doctor of doom purveyor of negative feedback.  However he was actually preparing my parents for the worse case scenario.  If I did not die, then however I turned out, would be bonus in the eyes of my parents.  If I died then they were also prepared for that as well.  Anything above that was icing on the cake.
This is what I am trying to prepare you for in case you hoped for a full recovery and fell short at least you will be able to cope with that new possibility.
I apologize to people who are physically disabled.  I mean no disrespect for anyone dealing with a life altering affliction.  My reason for saying Brain Injury is the most insidious is because unlike loss of limb, or mobility, the rehab process is the same for all.  When it comes to Brain Injury, what works well for one may have little or no affect on a similar brain injured person.  With loss of limb, rehab is the same for one as it is for the other therefore success and achieving the fullest potential can be reached in a reasonable time. I am 40 plus years in recovery and I still don't have it licked.
So follow me through my blog.  I hope I can make you laugh.  I hope you will take from this a sense of reality that will prepare you for what is and will be as life altering for the survivor as it will be for you the caregiver.My hopes and prayers go out to those who like me have a new reality called My Broken Brain.