Life After Traumatic Brain Injury

Life After Traumatic Brain Injury

By Sonnet Gomes

My Journey Begins

I will never forget March 18, 2019. It’s hard to imagine it has been just one year ago. It was evening when I got a phone call from my dad. He told me my 2-year old daughter Anastasia had been rushed to the ER for convulsion and fever.

We have a family history of febrile convulsion, so at first I was not particularly concerned. But, I was wrong; it was not an innocent febrile seizure. Instead, my dearest Anastasia was seriously ill. Once at the hospital I was informed that Anastasia had viral encephalitis. The doctor explained viral encephalitis is an inflammation of the brain caused by a virus. The result of that inflammation turned my beloved daughter into someone we do not even know.

My journey with traumatic brain injury began that day. Since then I have visited almost every pediatric neurologist in the region to give me insight into the damage done by TBI. The insight I’ve gained has revealed there are many difficulties for those unfortunate humans living with TBI. I have seen both the worst effects of TBI and a few small rays of hope. Now, I feel an obligation to share what I’ve learned with others who are dealing with the results of TBI in hopes that I can help them get through it.

What Is TBI?

The term Traumatic Brain Injury (TBI) defines itself. It is associated with significant trauma or injury to the brain or damage done by infection of the brain. Injury from an accident or traumatic event are the most common cause of TBI. The second most common cause of TBI is cerebral infection. According to  ER records, almost 85% of the TBI cases result from one of these two causes.

Injuries

The first category includes injuries from falls, motor vehicle accidents, sports, or physical violence.  Depending on the severity of the incident, the damage can range from mild to severe TBI.  Do not underestimate a fall from your bed. The height may be low, but the impact can be profound. The same goes for falls from ladders, stairways, or bicycles. Please do not wait for symptoms to develop, get immediate help.

Accidents related to vehicles cause most of the TBI seen by physicians. In vehicular accidents concussion is the usual culprit and can result in a severe case of TBI. Another major source of TBI is athletic endeavors. Sports are associated with high speed and collision. Thus, there is a good chance any sports accident or injury can cause severe brain damage. Furthermore, exposure to explosive events like gunshots can cause a severe impact on the brain. The extreme pressure caused by the explosions damages the neurons and their connections.

Infections

Any infection in the brain will undoubtedly damage brain cells.Viral encephalitis causes the brain to swell, effectively squeezing the brain causing often irreversible damage. If the expansion caused by the swelling is low, then the damage may be small and considered mild. Otherwise, with dramatic swelling the damage is defined as severe TBI.

Meningitis infects the three outer layers of the brain causing a breakdown in the connection among brain cells. Encephalitis, another common infection, damages the white and grey matter often leading to death or TBI. Viral encephalitis because it involves the temporal and frontal lobes, is often characterized by psychiatric features, in addition to memory deficits, and aphasia.

Encephalopathy is often associated with a patient’s post injury or infection condition.  Wikipedia defines encephalopathy as “a broad term for any brain disease that alters brain function or structure”.  My daughter fits this definition. It is making her healing after traumatic brain injury tough.

Signs & Symptoms Of Mild Brain Injury

Mild Traumatic Brain Injury. (The injury and resulting damage are temporary)

  • Loss of consciousness
  • Headache
  • Nausea
  • Fatigue
  • Disturbed sleep pattern (too much, or not at all)
  • Gait disturbance, including loss of balance
  • Anger management issues
  • Blurred Vision
  • Memory issues
Signs & Symptoms Of Moderate To Severe TBI

Moderate to severe Traumatic Brain Injury is more devastating and permanent

  • Loss of consciousness for a more extended period
  • Seizures or Convulsions (long-term)
  • Long periods of sleep
  • Loss of coordination
  • Numbness in the limbs
  • Confusion
  • Slurred Speech
  • Loss of speech
  • Mood Swings
  • Behavioral changes
  • Hallucinations
  • Altered mental status
  • Cognitive decline
Is There Any Treatment For TBI?

Adapting to TBI is not easy. I want my beautiful daughter back the way she was, but that is not reality.  All the impact-syndrome and post-traumatic amnesia has overwhelmed me. Quite honestly, such emotions have in many ways made things harder when dealing with my daughter. However, there is hope for people with TBI. Medications and rehabilitation can sometimes bring them back to their pre-trauma condition. For people with severe injury such interventions can at least make life more comfortable. Medication is mostly used to control seizures. Other relaxing drugs are used soothe the brain and help it to heal.

Physical and Occupational rehabilitative therapies can improve a patient’s physical and mental activities. Studies show such rehabilitative activities help in reconnecting neurons in the brain, enhancing the signaling between them.

Difficult to admit, but it is not possible to have the same person back after a severe TBI. But, you can bring to life a new person with proper health care, nutrition, and rehabilitation.

Signs Your Loved One Is Improving From TBI

We all want our loved ones to recover from the TBI. No matter how much they have changed, the new person will be loved with the same intensity and care as before their injury.

Signs your loved one is recovering from encephalopathy or Post-Concussion Syndrome may be small but positive visible signs can’t be overlooked.

  • Improved emotional responses
  • Better coordination
  • Becoming more social
  • Improved communication verbally and with gestures
  • No more constant headaches
  • Regular sleep pattern is coming back
  • Getting involved in the activities, they used to like
Emotional Impact Of TBI

Any Traumatic Brain Injury affects the patient both emotionally and physically. Nevertheless, the emotional impacts are sometimes more long-lasting than the physical ones. You may find your loved one exhibiting symptoms of severe Depression. The happy, jolly person you used to know can turn into a sad clinically depressed person after a brain injury.

People with TBI often become more anxious. Even a small challenge will make them tense as hell. Yes, it is difficult to see them like this, but it is the reality. Anger and irritability are common as frustration and anxiety combine in destructive outbursts with many TBI survivors. You will be required  to deal with poor anger management if your loved one is a survivor.

Insomnia and Mood swings will be the everyday issues. You may also see some mental symptoms with a concussion, including blank stares and seizures.

The Financial Impact Of TBI

I had to re-organize my financial plan after my daughter’s TBI. Now I am saving money to keep up the highest quality treatment for her. It is affecting my professional and personal life; however, family comes first. I have cut down expenses in other areas and increased my contribution to health care. I have not had to take on a second job, at least for now, but honestly, TBI is expensive.

Life With TBI Is Different

Your family will change if you have a member with TBI. Your life will be different from others. Priorities and preferences will change dramatically. It becomes difficult to cope with the challenges of TBI and living a normal life. However, we keep fighting against the odds, fighting to make sure my daughter has every comfort I can give despite her distress. Hopefully the information I have shared will help others confronting TBI.

The Human Need To Reunite

The Human Need To Reunite

By Anna Hessel

 

Getting It Together

We all have a basic need to reunite with those who are important to us; there are many types of reunions: high school, college, and family, being some of the most popular.  We see television, movie, and band reunions, all of which bring together memories which allow us to reminisce about times gone by.

Reunions in the Media

There are a multitude of films about reunions between old flames and friends – I have watched dozens of these movies on the Hallmark Channel, alone.  I am sure we can all remember “Class Reunion”, “Peggy Sue Got Married”, “Beautiful Girls”, “10 Years”, “The Big Chill”, “Romy and Michele’s High School Reunion”, and “American Reunion”, just to name a few.

Novels Too

Multiple novels about reunions fill the book shelves. “The All-Girl Filling Station’s Last Reunion” by Fannie Flagg, “After The Reunion” by Rona Jaffe, “The Odyssey of Reunion” by Abhisek Pani, “Blake’s High School Reunion” by Marcia Carrington, “Murder at the High School Reunion” by Steve Demaree, “How to Prepare for your High School Reunion, and Other Midlife Musings” by Susan Allen Toth. There is a bevy of books titled “High School Reunion”, and plethora of ones simply titled “Reunion” or “The Reunion”.  There is even “The High School Reunion Diet: Lose 20 Years in 30 Days” by David A. Colbert – this particular book reminds me of my husband’s ten year high school reunion – lots of preparation on our part to visit three hours with many people he barely knew.

How To Survive Your Class Reunion

Psychology Today has dubbed the high school reunion as “psychological time travel”.  Guideposts Magazine offers several tips for enjoying your class reunion.  A good start is recognizing that many of your old classmates may also have anxiety about attending. A great suggestion Guideposts made was to reconnect ahead of time on social media. Another suggestion was to pick up the old year book and leaf through it, reminding you of the faces, the fashions and the vibe of the time.  When at the event introduce yourself, get up and move around, ask others about their current lives, and spend time with people you didn’t know back in the day.

New Eyes

Definitely avoid heated and divisive topics such as politics, instead focus on the memories. Everyone has experienced setbacks and troubles, as well as happiness in their lives since you knew them.  Allow the passing years to disappear by looking at everyone with new eyes and a forgiving heart.  Don’t obsess about losing that last 10 pounds before you reunite; the fact is  we all age physically, even the prom queen, football star, and cheerleaders.  If it is any comfort, Chicago Magazine tells us, “your 50th high school reunion will be much better than your 20th.  Let’s face it, folks, as we age, we learn to not sweat the small stuff”.

African-American Suffering

Whether called reunions or just “family get-togethers” families have gathered for centuries for no other reason than to celebrate family heritage, faith and fun. Reunions not only give a sense of intentional preservation and family bonding for people, but satisfy a need to nurture. In the United States reunions have deep roots in African-American history, painfully recalling slavery and its toll on family units as they were torn apart and sold off to various plantations.  African-American family reunions may well date back to the Emancipation.  “Information wanted” ads were common in newspapers of the day, and may be the root of African-American reunions as people searched for lost and separated family members.

A Shifting Population

Between 1915 and 1940, a period dubbed as the “Great Migration” close to 4 million African-Americans traveled south-to-north, many heading to New York and Chicago.  The enormity of that black population shift encouraged the growth of family reunions in that demographic.  The significance of extended family formed the idea of the need for togetherness at specific times when all could be reunited.  For more information, please visit the website of the Smithsonian National Museum of African-American History and Culture: #APeoplesJourney.

Today, family reunions in all cultures symbolize heritage, fellowship, and a sense of community.

Ms. Hessel is a member of the National Society of Newspaper Columnists

Trump, Sick To Death

Trump, Sick To Death

D. S. Mitchell

House Bound

I’m stuck home, recovering from extensive foot surgery. I have watched all the NetFlix offerings that interest me.  I am now resorting to live streaming on Hulu. I switch back and forth between CNN, FoxNews and MSNBC like an agitated Adderall addict. One thing I have noticed over the last several weeks is that Trump appears to be in poor health.

Unannounced Visit

On November 17, 2019 Trump made an unannounced and seemingly unplanned trip to Walter Reed Medical Center. Trump decided on a motorcade instead of his standard helicopter ride. The visit did not seem to be planned despite White House denials of any emergent situation.  A source familiar with the events  described Trump’s visit as “abnormal,” but added that Trump, 73, did not seem to be in any physical distress later that evening.

Squelched Questions

White House press secretary Stephanie Grisham, attempted to tamper down the questions, saying “he’s in good health and it was a routine checkup as part of his annual physical.” Grisham furthered her explanation saying, “Trump decided to get parts of his physical done early because he had a “free weekend” in Washington. Grisham did not respond to questions about why Trump did not get his full physical exam — which typically takes 4 hours or less — done over that open weekend. When pressed by reporters, Grisham vehemently denied Trump had any undisclosed health issues.

Not Routine

According to Grisham Trump underwent a “quick exam and labs.” Several experts familiar with White House medical procedures said that Trump could have gotten ‘routine’ lab work done at the White House’s on-site clinic, seeming to support the theory that Trump needed tests that couldn’t be done there.

Sunday Morning

On that November 2019 Sunday morning Trump took to Twitter telling the nation he planned to finish the ‘second part of his annual physical’ sometime in early 2020. Trump’s February 2019 full physical exam revealed he had increased his daily dose of Rosuvastatin, a medication used to treat high cholesterol. Additionally, Trump’s 2019 physical used a coronary calcium CT scan score of 133 to diagnose heart disease.

Fast Forward

As I said, I am watching a lot of streaming TV. One thing has become increasingly obvious, Trump looks worse by the day. He appears to be in poor health. I am speaking of all aspects of his health, his physical, mental, and cognitive health.  During recent public appearances he has looked ill. I of course, keep wondering if it has anything to do with that unscheduled November visit to Walter Reed Medical Center. I really want to know what sent Trump to the hospital that day back in November, I doubt if it was as routine as the White House would like us to think.

Declining Health

During the last couple weeks Trump has looked worse than usual. He has become more heavy-handed with the orange makeup, that is obvious. During a major speech in India and later at a press conference after the speech, Trump fell into rambling incoherence; slurring and mispronouncing common words. On that trip he was described as wobbly and sweating profusely. At a Saturday night rally in South Carolina amid the primary vote he again looked bad, causing viewers like myself to question his health.

Incompetent

Rumors have persisted for years that Trump is an Adderall addict. Trump does in fact show evidence of stimulant abuse. Photos have captured the enlarged pupils.  And anyone listening to a Trump speech is familiar with the snorting and sniffing between sentences. The nasal dysfunction is most likely related to sniffing Adderall. People surrounding the president report manic screaming fits, and sleeplessness.  In a recent interview acting Chief of Staff Mick Mulvaney confirmed, “He (Trump) never sleeps.”

Another Collapse

It’s obvious why Donald Trump is unraveling. We are on the verge of a pandemic that has killed its first victim in the United States.  Despite Trump’s bluster, his incompetent, cobbled together administration is incapable of dealing with an emergency within our borders. And he knows it. News that he can’t suppress or manipulate is terrifying to him. Last week the stock market dropped 3,500 points. There were two days of declines of more than 1,000 points. One of those days, posting a loss of 1,192 points making it the biggest one day loss in stock market history. All together the stock market is off 15% in one week. For a man who has basked in the glory of a raging bull market, and good economic numbers, such losses would be terrifying and certainly threaten his re-election chances.

Potential Blow Back

As a malignant narcissist Trump is incapable of empathy. He can act concerned when he anticipates a negative impact on Donald J. Trump.  As Bill Palmer noted in a recent on-line article, “He feels bad for his fellow aging white male criminals when they get harsh sentences, because he fears the same thing will happen to him if he loses the election”.  But there is nothing to suggest that he cares if people will die from the coronavirus. Nor does he seem care if the average Joe will face economic hardship. At a hastily called press conference, looking bleary eyed and edgy he down played the chaos and uncertainty of the economic markets and indicated the coronavirus was being hyped by the Democrats as a partisan tool to defeat him in November.

Inside The Trump Brain

Trump is a known ‘germaphobe’. He may even be worried that he’s going to catch the coronavirus and end the campaign rallies for a few weeks.  For all the obvious reasons, and many not so obvious he is terrified. His fear is palpable. Despite a campaign war chest approaching a billion dollars and promised help from the Russians Trump’s paranoia is on full display. He knows a failed response to an epidemic and a sinking economy will threaten his 2020 prospects. Joe Biden, a man Trump fears so much, he got himself impeached trying to discredit him – dominated the primary contest in South Carolina.  Make no mistake about it, Trump is disintegrating before our eyes.