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Answers to your personal questions from someone who
cares........ 
DEAR PAT: My
father had heart failure and it took him 20 minutes to bring him back. The
doctor gave him medication and he was supposed to wake up in about 10 hours. It
has been over 72 hours and his is in a coma. His heart and organs are
functioning well and a brain scan showed no signs of stroke. Can you tell me how
long it takes to get out of a coma?
PAT'S RESPONSE:Afraid I can’t answer that one. These things vary from
patient to patient and are always hard to predict. The physician treating
your father is the best source of information about his particular case. It
sounds like your father may have experienced what is called a hypoxic coma.
This means that there is oxygen deprivation to the brain. A heart attack is
one of the most common causes of hypoxic coma. Because the brain does not
store oxygen, the brain needs a constant supply. If that supply is
interrupted, brain cells begin to die.
Generally, the longer in a coma the less likely there will be a good
outcome. However, if your father shows good brain function, there is a good
chance he will "emerge" from his coma. Sensory stimulation may help him
emerge from the coma, although there is some controversy over the
effectiveness of this intervention. After he is awake, he may need a
significant amount of rehabilitation therapy and may experience many of the
problems with attention, memory and behavior that are experienced by other
survivors of brain injury.
DEAR PAT:I’m a 27-year-old brain injury survivor. I’m
going to college, but I’m having problems with math. I’m working with disability
services. Otherwise I’m doing fine in school. Should I keep going or give up?
Math is the only subject I have real problems with. I was treated in the
emergency room and released. I didn’t even spend one night under observation! Is
this weird?
PAT'S RESPONSE: A college student having trouble in math? Shocking!
Unless you’re writing from MIT, I doubt you’re rare. I’m quite sure
graduation rates across the country would plummet if every student who is
doing well in all other subjects "gave up" because of math.
Most people are able to overcome math-related learning disabilities or
other deficits to make it through an undergraduate math or statistics
course. If you just need to get through one course, you might consider
auditing it before you take it for credit. Sometimes exposing yourself to
the material without the "pressure" of having to make a grade helps. If your
school offers math in large classes with little individual attention, find
out if you can take the course at a smaller school and transfer the credit.
Also, many students need tutoring. In most cases, it’s worth your investment
of time and money because you get individual help tailored to your needs.
Discuss your needs with your instructors. Request untimed testing to take
pressure off. If you have anxiety related to math or testing, consider
seeing a counselor to help develop strategies for coping. Most schools offer
free counseling services to students.
If you’re taking math because it’s a required part of liberal arts
curriculum, your school may be willing to waive or substitute the
requirement for a student with a documented disability. (For example if
Calculus is required, and you’re a History major). On the other hand, if
you’re trying to enter a field that demands the use of math as part of the
profession, you may need to consider if that profession is right for you.
Consider another field that better suits your strengths and abilities. You
can’t be an engineer without calculus, a psychologist or economist without
statistics, or an accountant or pharmacist if you make frequent calculation
errors. Find a field of work that plays to your strengths.
There’s nothing weird about having a brain injury that resulted in math
problems. Math is a complex cognitive task requiring sustained attention,
symbolic processing, abstract reasoning, good memory, and the ability to
process multiple steps. Even minor brain injuries that disrupt any of these
abilities can lead to problems in math skills.
DEAR
PAT:I had a TBI in October 1996. The thing I notice now is that I obsess
over certain things. For example, I’ll take a bottle of Windex and some paper
towels in my room and start cleaning EVERYTHING. What’s up with that? I mean
it’s bad enough to have obsessions, but getting into a cleaning frenzy?
PAT'S RESPONSE: Maybe you can clean Pat’s office? On the other hand,
even you might not be able to handle that!
You may be experiencing symptoms of obsessive-compulsive disorder. It
depends on how often you obsess and how much it disrupts your life.
Obsessive-compulsive disorder has been linked to several areas of the brain
including the frontal lobe and the neurotransmitter called serotonin. It is
possible that damage to certain parts of your brain such as the frontal lobe
may have contributed to your symptoms. Medications affecting serotonin such
as Prozac and Luvox have been used with some success in treating OCD. In
addition, cognitive-behavior therapy can be very effective, particularly for
milder cases. Don’t be afraid to seek help. Talk to your physician or make
an appointment with a psychiatrist or psychologist who can help you evaluate
your symptoms and discuss options.
DEAR
PAT: had a truck accident 7/30/98 and I sustained a serious closed head
injury among many other injuries. All of the doctors I’ve been seeing are
thoroughly impressed with the recovery that I have made, but now that I’ve been
out of therapy since January, the neuropsychologist recommended that I go back
into therapy just when my life started to regain some normality. I am 29 and had
spent the last 9-10 months recovering with my parents. Now, my mother doesn’t
want to let me out of her sight. I can understand her concern, but I’m tired of
my whole life being about the accident. I’ve recently gotten engaged and I want
to put my time into my relationship. I don’t have a problem going back into
therapy, but I want to be able to do it here, with him, instead of living with
my parents again. I’ve lived on my own since I was 17 and managed very well.
What should I do?
PAT'S RESPONSE:Pat can’t figure out from your question why your
neuropsychologist has suggested you go back into therapy, or what kind of
therapy is being suggested. It sounds like you’re getting a lot of advice.
Remember that these are choices about your life and you get to make them.
Brain injury or not, you’re an adult and you’re entitled to make choices
about your own life. Consider what the neuropsychologist suggests. Be sure
you understand what his or her concerns are and why therapy is being
recommended. Sometimes people try to get their "old life" back too soon.
Maybe that’s the concern. However, discuss this with your fiancée, family,
friends and other people you trust. You can always try therapy for a while
and change your mind if things are going well. Or if you and your loved ones
think you are doing well now, you could try life without therapy and try it
later if you need help. It’s really up to you.
As for your mother, this is not at all uncommon. Your mother is likely
very concerned that you can’t handle things or will get hurt again. She may
be afraid that you’re trying to do too much, too fast. Maybe she’s concerned
your fiancée doesn’t understand everything about your injury. She could be
right. Talk with your mother, fiancée and others about those concerns. Find
out if the medical professionals that work with you share her concerns. Then
make an informed decision. Remember that it’s your life. As an adult, it
perfectly appropriate for you to start your own household and, at some
point, your mother is going to need to let you and your fiancée live your
own lives and make your own decisions – whether you’ve had a brain injury or
not.
DEAR
PAT:I have a friend who was in an accident over a year ago. He says he had a
brain injury and now uses this as an excuse to abuse his wife and the people
around him. I do believe that people suffer from brain injuries, but I also know
this person’s reputation for conning money from others. Is there physical
evidence involved in the diagnosis of brain injury or do the doctors just go by
the patient’s reported symptoms? We have been told that all of his inappropriate
behavior is not his fault and is due to medications and injury, but what I fail
to understand is that he is the exact same person he was before the accident.
Only now he is suing for a lot of money and he has the doctor’s support. Help!
We don’t understand.
PAT'S RESPONSE:Why are you friends with a wife-abusing con artist?
Seriously, if his "abuse" is physical, it is a crime and he should not be
allowed to continue harming other people. Even if his "abuse" is just
verbal, why are you, his wife and "others" continuing to put up with it?
Having a brain injury is not a license to treat people badly.
Regarding the "evidence." Sometimes there is physical evidence you can
see with brain imaging (CT, MRI). However, sometimes the effects of injury
cannot be directly observed and doctors use patient and family reports of
symptoms and neurospsychological testing (tests of things like memory and
attention) to gauge the effects of injury. Can people lie? Yes. Can they
fake injury effects? If they know what to fake and how to fake it, it could
be done. Is it easy to fool a good, well trained medical professionals? No.
But it can and does happen. Doctors are fallible just like all of us.
It is also not uncommon for an injury to cause someone who had
pre-existing problems with anger management or impulse control to get worse.
Frustration resulting from memory or attention problems, physical pain, or
mood swings can contribute to making an already angry and aggressive person
even more angry and aggressive.
The thing to remember is that you don’t know what the medical
professionals know. You probably don’t know his medical history, medial
records or the results of medical tests. Unless you’ve talked directly to
his doctors, you don’t even know exactly what he has been told because you
are getting information second hand. Also, keep in mind that if this is
litigated, there will likely be professionals on the other side that will
scrutinize things very carefully to be sure he really has suffered an injury
and to challenge his doctors’ findings. Unless the opposing side just
settles the case, this person may have to undergo several evaluations and
depositions. Also, if the accident wasn’t his fault, he may be legally
entitled to some reimbursement for medical expenses, lost wages, and pain
and suffering even if his injuries didn’t cause his angry, aggressive
behavior.
Probably the best thing for you to do is not to worry too much about it
and avoid spending lots of time with someone who isn’t pleasant to the
people around him. Hopefully the system will work for the best. Most of the
time it does. Sometimes it doesn’t.
DEAR
PAT:I am the wife of a TBI survivor. We have reached a point in our lives
where the resources are gone. My husband has had rehab, counseling, therapists
for cognitive functioning, etc. We are currently seeing a marriage counselor
through my husband’s vocational rehabilitation case manager who is pulling
services since my husband will not be employed in the near future. What
resources do he have after everything else has been used? He has been seeing a
psychiatrist, but they haven’t found a medication combination that works. He
suffers from mood swings, cannot hold down a job, and does nothing but sit all
day and play on the computer. He has suicidal tendencies and gets angry easily.
Please tell me where I can find more resources.
PAT'S RESPONSE:Spouses of brain injury survivors with emotional
control problems really understand the meaning of "for better or for worse."
One of the hardest things to do is to adjust a marriage to life after brain
injury. It is even harder than adjusting to life after other kinds of
serious illness or injury because behavior changes often make it seem as if
the TBI survivor just "isn’t the same person."
Your question is a good one. Unfortunately, there is no easy answer.
There are a number of websites that are devoted to TBI and there may be a
Brain Injury Association in your area that can help. Some websites are
available through the "links" page on this site. Find out if there is a
brain injury support group in your areas or in an area nearby. Other TBI
survivors and family members of TBI survivors can often given helpful
guidance since they are likely to have encountered similar problems. If you
belong to a religious community, ask for help. Many religious groups and
organizations may be able to assist with providing social support, respite,
or spiritual counseling. Couples therapy is a good idea, especially if the
counselor is educated about the effects of TBI. If you can, locate a
psychologist or counselor in the area with experience helping families with
brain injury. Consider consulting them on an individual basis. Family
members caring for TBI survivors experience high rates of depression. You
need to take care of yourself as well as your spouse.
DEAR
PAT: I work for an organization for people with developmental disabilities.
I recently received a request for information for a 15-year old girl with a TBI.
She is being released this weekend from the therapy facility and has no place to
live. She is being placed in a residential home with emotionally and
behaviorally challenged girls. I am unable to find her an alternative place to
live. There is no agency in my area that provides residential care for TBI under
18. I fear for this young lady’s well being. I would appreciate any suggestions
you may have. Thank you.
PAT'S RESPONSE:problem of limited resources is serious in some
places. It’s not clear why she is being placed in a residential facility. If
she has no family available or is in the custody of the state, she could be
placed in a foster care home. Some states have foster parents with medical
training who can provide homes to medically challenged youth. However, if
this isn’t an option, Pat suggests you locate a hospital that treats
pediatric brain injury. They should have a social worker or services
coordinator who could point you to services and professionals who deal with
children with TBI. Your best bet may be to work with existing agencies to
make modifications that will best help this young woman. Good luck!
To the
Parent looking for TBI professionals in Nebraska. Pat doesn’t have anyone
specific in mind. You might try contacting the Psychology Department at the
University of Nebraska-Lincoln for names of therapists or neuropsychologists.
Locating a hospital that treats brain injury could help you locate a neurologist
or physiatrist. Also, following is information for the Brain Injury Association
of Nebraska. They probably have a list of resources in your state.
Brain Injury Association of NEBRASKA
President: Kathy Feldman
Co-Executive Directors: Jan Kauffman & Sharon Auld
PO Box 124
Gothenburg, NE 69138
UPS PACKAGES: 1108 Avenue H, Gothenburg, NE 69138
Phone: (308) 537-7875 or (308)-537-7663
In State: 1-888-642-4137
Fax: (308)-537-7663 >> Please Call First!
E-Mail: bi13135@navix.net
Web Site:
http://www.biausa.org/Nebraska/bia.htm
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