Sunday, 29 April 2012

What can I expect shortly after TBI?

Well I didn't go into depth of what to expect when it comes to a traumatic or acquired brain injury.  So lets dust of the long term memory and see where that takes us.

I have said in the past, not sure if in this blog, that brain injuries are as unique as they come.  The treatment will also have to be tailored to the individual.  Not one brain injury is alike and that is why they are hard to treat in rehab.
Most other injuries have a beginning date and an end date, so to speak.

A broken arm takes immobility for about 6 weeks and within a few more weeks you are back to your old activities.

The treatment for loss of limb is similar to all limb losses.  There is the healing, the fitting of a prosthesis, and retraining on how to compensate for loss of weight, (the limb loss causes balance issues as the brain compensates for difference), Acceptance by the individual. Though some may take longer than others, the actual healing from the loss has a start and end date.

Brain injury is the great un-equalizer if I could invent a new word.

I may have damage to my temporal region of my brain and someone else has an identical injury but it affects us in completely opposite ways.

Now, I am probably going to be hung out to dry by the feminist movement for this next statement but it begs to be said, a female brain is wired differently than that of a man's thus the same injury may have marginal affects on a male and pronounced affects upon the female or vise-versa.
If the speech region is injured, the male may have lesser affect or may be heavily impacted and require therapy whilst a female who from early on developed a stronger communication skill has her speech barely impacted.
She may notice a huge drop in her ability but because speech developed in several regions the impact hardly make a blip on the scale and she requires little or no therapy.

It takes a skilled Doctor or Therapist to identify the individual needs of the brain injured.  The recovery may be short lived or may require years of constant training.

As soon as you the caregiver can take an anger management program, the better.
I am not accusing you of losing it.  I recommend this for the injured as well when he or she is capable to do so.


You will be taught how to edit your responses to certain situations.  You will be taught how to build up a host of coping skills that you can eventually rely on when and if the crisis arises.

Chances are, there will be many challenges.

A brain injured person is more likely to act out inappropriately.  He/She will, like you, get frustrated and even angry.  If you have a new skill set you can diffuse the situation before it gets out of control.

Brain injury enjoys a 90 percent divorce rate.
Violence may become a dire concern that even forces you to leave the injured loved one, merely for self preservation.
Do not stay in a violent relationship.  Your life is so much more important.

So you can expect,
1) A longer healing time.
2) Possibly multiple regions of the brain injured.
3) Anger
4) Frustration
5) Possibly Violence

What do I mean multiple brain injuries?
A fall from a bike causes a concussion.  The brain bounced off the frontal region of the skull and then swished back and bruised the occipital region of the brain.  Now you have the initial injury up front that alters your speech and the back of the brain alters your blood pressure.  (Just a hypothetical example)

My short term memory was impacted.  My ability to recall information stored in this broken brain sees me stutter whilst I try to relocate it.

My speech was affected in the beginning.  I couldn't say winter or tomato.  I could not identify everyday items like a comb or a paper clip.

I am not an expert unless I qualify by simply living for 34 years inside this broken brain.

I do have wisdom, but what works for me may be completely foreign to the next.

You will require several tests to determine all that is wrong post injury.

I wish we could all get an annual brain test for free.  In the event of a brain injury, you have a before snapshot to compare to the test, post injury.

Since we don't have that luxury it is so important to write down your observations of the brain injured and share those findings with others who are close to that brain injured person and if there is a consensus, take those findings to the therapist

I couldn't perform math prior to the injury and after the blood clots were removed from my brain, my math skills improved dramatically.

The downside to that miracle is, my learning skills dropped.  It takes me 3 times longer to get the answer.

It doesn't bode well for schooling where you have an exam that is timed.  My math answers may be 100 percent right but I completed only 1/3rd of the test.  A failing grade so to speak.

My concentration is also damaged.  I have a hard time staying on task.  The phone rings and I forgot what I was doing prior to that event and go onto something else. I am then accused of being incompetent or outright lazy.

I know I am fortunate because so many others have greater challenges than I. Like all brain injuries the problem is the longevity of the injury.  Permanent means just that....forever....

I have gotten accustomed to having to make several trips back home to fetch my thermos of coffee, my cell phone and even my wallet.

This past week, my wife had to drive 75 miles to where I was working to bring my Hand Held Computer, required to print out invoices to my clients.  I had to return home for my cell phone.  I searched for my phone last night and because the ringer was off,  took longer to find where I put it.  I had to check the back of my 5 ton truck twice to see if in fact I remembered to close the back door. I was expecting an important call on the day I misplaced my phone and missed the call due to the volume being turned off. Twice this week I got into bed and remembered my alarm on my cell phone would not work from the kitchen where I had left it and had to get up again to retrieve it. I went to the grocery store when my wife called informing me that my wallet was at home.  During the same week I went to the mall and had to come back for said wallet. I forget to unplug the phone from my hand held computer and receive no calls for the remainder of the night. I have forgotten to turn off my one cup coffee maker twice this week.

The above is a shoddy snapshot of what I face on a daily basis.  I say shoddy because this is what I could remember from the past week.  There are so many moments of forgetting it's hard to recall all of them.

Often times, the events pile up. The frustration level for both my wife and I can run high.

She had a hard time accepting my disability too.  She even asked the doctor why it was I can remember  one thing and not another?
It is the nature of the beast.
You the caregiver will be challenged every step of the way.  Ensure you prepare for a long hard uphill climb. We measure accomplishments however small as giant leaps.
Look for methods that the loved one can utilize to improve or replace the region the barin has been affected by.  A cell phone can act as a memory and a reminder device.  Notes on the mirror, Did you flush the toilet?
Did you wash your hands?  Did you brush your teeth?

Blister-packs can assist in remembering to take daily medicine's.  A phone call can do the same.

Initially though you will meet with your G.P.
A neurosurgeon
Possibly a Neurologist.
A Neuro-Psychologist
A Therapist.
Ask questions.  Take notes.  Share your observations with the doctors or therapist.
Your loved one will take one or two neuro-psychological  tests.
This test lasts several hours and tests the brain functioning in detail.
Word finding, memory, memory recall, vision and even peripheral vision will be tested.  The left vs right hemispheres of the brain will be tested (a right handed person should be faster than things done with the left).
Mine was the opposite after the injury.
Divergent thinking will also be examined. The list goes on.

Accept where you are.
Don't use your past as a guide or marker to determine your recovery rate.
Measure your progress by how you overcome the challenges you now face.
Don't feel lesser of a person if you find you need to use help in the form of notes, a memory prosthesis like an Iphone to recall appointments.  Embrace them, they will reduce your anxiety levels.
Anticipate and accept the loss of friends.  Sometimes it is how they (the friend) cope with the loss of their friend.
Join a support group...Both of you!
Your loved one, especially if he is a male may feign at joining a group because he does not want to compare himself as disabled.
That does not mean that you cannot.  The caregiver needs all the support she can muster.  Join as soon as possible.  If there is not one in your area, go online and you will find all brain injury groups are a wealth of support and resources that will help you navigate this new and sometimes challenging world.

Find out what the government offers in the form of assistance.  They(the government), love to offer things to the disabled but enjoy hiding them from you by changing the name of the agency, or by burying the items so deep in red tape where it takes a genius to discover them.
Our local provincial government offers fresh water fishing licences to disabled for one dollar.  They cut the B.C. Ferry rate in half for both the disabled and caregiver.  They offer provincial campsites for free.  If your loved one is in a hospital away from home you can declare your hotels, meals and parking at the hospital on your tax form so keep your receipts for lodging,and fuel bill receipt.
The federal government will give you the tax back on your gas if you have or are disabled.  So continue to keep your gas receipts and get back up to $500.00 a year.

More to come....

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