The long road home may never end- Brain Injury Recovery

The way home has changed. The pathways were easy to navigate in the past. They are now a maze of jumbled vines and branches ready to trip me up.
I hadn’t left for that long. From what I remember the trails that were close by were well maintained. How did they become so jumbled in just a month?

There were bridges that very recently connected to each other. The supports have vanished.

The older parts along the way home haven’t changed. They don’t mean the same thing to me, but they are in their place. It’s the latest developments, the real estate has shifted. Sometimes I remember where things were so short a period ago and then I forget. It’s like a giant fog came and rearranged the landscape.

And such is the recovery process from a brain injury.

At times memories are clean cut and clear. At others they are gone. Each day brings new challenges, new solutions, new frustrations.

What works well with one patient is often the opposite of what is needed in another.

It is very common for a patient with a brain injury to deal with changes in memory, concentration, response time, planning and problem solving, initiative, flexibility, insight, impulsively, control of anger, talking, behavior, dependence, emotional stability, depression.

There have been some advancements in treating brain injury but many more are still in the study process. One important finding in 2006 was reported by Science Daily.

“We can theoretically take a single brain cell out of a human being and – with just this one cell – generate enough brain cells to replace every cell of the donor’s brain and conceivably those of 50 million other people,” said Dennis Steindler, Ph.D., executive director of UF’s McKnight Brain Institute. “This is a completely new source of human brain cells that can potentially be used to fight Parkinson’s disease, Alzheimer’s disease, stroke and a host of other brain disorders. It would probably only take months to get enough material for a human transplant operation.”

Onto the reality of dealing with a brain injury.

Recovery from a brain injury is a loose term. The truth is most people who suffer a traumatic brain injury will have some limits. Brains don’t recover the same as a broken bone. The deficits caused to the brain are generally permanent. Expecting a full recovery can cause a patient and their families to experience denial, frustration, disappointment, and even worse, extremely unrealistic expectations and planning. Hope is a positive element but reality needs to play a large part when it comes to the ‘recovery’ period of a brain injury.

There is no magic number when it comes to the time it will take for visible recovery to happen. Some people take six months to see progress, some a year, some take several years and some will never see a big improvement. Less severe brain injury patients typically recover quicker and those with massive brain injury take longer periods.

Recovery comes in small peaks and valleys. There is no consistent pattern though with brain injury cases.

Miracle cures are rare. There is no magic formula that speeds up the process. While using the most up-to-date therapies are beneficial they are not a cure.

IQ scores don’t pick up all the deficits when it comes to a brain injury. Testing for IQ can be misleading. Task testing is a better indicator on what damages have occurred. As the Web site Get Real Results puts it traditional intelligence tests bear little relationship to the mental processes required for successful everyday functioning. They are composed of brief, highly structured, artificial tasks, that emphasize old learning and over learned skills.

MRIs don’t tell the whole picture either. Brain scans may look completely normal and yet there are serious damages that are the reality of a patient’s life.

Most patients with a brain injury will not use that injury to their advantage. Most are frustrated by the challenges they face. Patients though do have a tendency to become dependent on their support teams. This is a learned dependency and can be unlearned.

Psychotherapy needs are very different for those with a brain injury than the rest of the population. This is not the time to cure the past. This is a time period that requires a structuring, supportive, problem-solving approach.

Many brain injury patients have to take medications. Some of those drugs are used to treat various emotional, behavioral, and even cognitive problems after brain injury. Some though can cause a patient to lose footing on their way back. Mild tranquilizers are one of those drugs. In a non-injured brain they may calm a person, in an injured brain they may cause memory problems, poor judgment, and emotional control problems in head injured persons.

With brain injury recovery is not known. There are no magic bullets. Learning strategies to cope with deficits can be more important than holding out for a total recovery.

It’s a long road. There are many blockades in the process and there is no guarantee that the final word will be positive.

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