Rehabilitation after traumatic brain injury
(By Vimal Kodai)
Inspiring Quote for post-traumatic injuries sustained individuals
Major Causes of Traumatic Brain Injuries
Rehabilitation after traumatic brain injury
Abstract from: Medical Journal of Australia (MJA)
Originally from an article by: Fary Khan, Ian J.
Baguley and Ian D. Cameron
Based on medical studies done recently, and as
per the courtesy of the Medical Journal of Australia (MJA), this article argues that there are several
factors involved in rehabilitation after a serious condition of traumatic brain
injury. It has been observed that recovery after a serious TBI (Traumatic Brain Injury) carries on its course at least 5 years after the initial impact of injury
sustained. Although, traumatic brain injuries affect people of all ages, and
that there are no restrictions to any particular groups or age groups of people
which may encounter such an injury, TBI commonly affects adults who are in
their prime. Traumatic brain injuries result from an external force to the
brain causing serious damage and permanent neurological dysfunction to it. In
most cases, there are no evidence or factual proofs that suggest the existence
of an eminent brain injury in an individual, but through the behaviour and by
the way the person handles situations and maintains conversations, there are
conclusive certainties that some areas of the brain have been affected and that
rehabilitation needs to take effect. In other cases of Traumatic Brain
Injuries, speech is distorted, balance and mobility of the person with an
acquired brain injury (ABI) are affected, paralysis may occur; part of the
brain may stop to function properly—resulting in strokes, seizures, epilepsy,
brain tumors, etc. Rehabilitation after TBI promotes and enhances psychosocial
adjustment of the individual. In many cases, rehabilitation may last up to
several years (from
2 to 10 years, or more),
but depending on the mindset and willingness of certain individuals with brain
injuries, based on their social surroundings, and depending on their
motivational insights and determination, psychosocial adjustment occurs at a
quicker pace and healing happens even faster. Attendant care and readily
available assistance are crucial requirements of a person who has sustained TBI
or an ABI. Being in a comfort zone and by obtaining a secure, safe and sound atmosphere
with someone who is trustworthy, the individual who is suffering from such
traumatic condition would be granted the abilities and first-hand support in
order to recover peacefully.
Traumatic brain injuries usually cause
impairment to the cognitive, psychosocial and behavioral aspects of
individuals. TBI has direct ties to the connectivity of neurotransmitters in
the brain. These may work very abnormally as they may take longer than
anticipated time to regenerate. In fact, these neurotransmitters and neurons in
the brain cells do not regenerate very much—only serious interventions, active
thinking, cognitive activities (reading, writing, playing cognitive games) and cognitive engagements (developing
new skills, or, adopting serious attitudes in doing common chores, artwork or
handicrafts), physical exertions
(exercising, walking, jogging, meditation, running, weight lifting, deep
breathing, practicing yoga, swimming, etc.,) and
keeping a very positive mindset in the forms of: positive thinking, positive
ideas, inspirational guidance, motivational insights and optimistic thoughts
may all lead to complete healing. It may take between two or more years for the
neurotransmitters in the brain to attempt to regenerate actively. As such, it
may even never start working as effectively as it did prior to the injury
sustained. In many cases, these cells do not regenerate as much as it should
have; therefore the individual tends to feel disconnected with his or her true
self. Most of the time, there is a feeling of unawareness, and a sense of
non-belonging is felt. Amnesia or short-term or long-term memory loss may be
experienced as a result of such feeling.
The burden that results from a severe brain
injury is very problematic and acute. A whole family and family unit suffer as
a consequence of a traumatic episode that has occurred to an individual. Life
changes in a split of a second and the future can be really scary and fearsome.
Rehabilitation is required at all costs.
INSPIRING QUOTES FOR ALL (Including survivors of ABI)
Rehabilitation after TBI varies from country to
country. Rehabilitation after a serious trauma and traumatic episode sometimes
does not happen at all to some individuals. Facilities and amenities,
healthcare and medical options, supportive people and educational backgrounds,
and, several other post-trauma supportive bodies and services are not always at
the disposal of many who have suffered such kinds of blows to the head. Brain
injuries sustained are typically very unpredictable as they vary from case to
case and people to people. Rehabilitation requires lots of insights and
positive guidance on the part of healthcare professionals. The latter have to
be very knowledgeable and experienced in order to provide their ongoing support
to the individual who has sustained the brain injury. Based on the Glasgow Coma
Scale (GCS) which ranges from 3 to 15 (3/15), severity of
cases, or at risk individuals are being given first-hand care and attention.
Each person who has had an acquired brain injury and/or traumatic brain injury
recovers at a different pace. Depending on the individual’s previous routine
daily activities and previous physical fitness level, recovery may take a lead
role by carrying on its course with much ease, or it may usually be dealt with
serious challenges. Support coming in various forms; namely: financially,
morally, spiritually, socially, educationally, emotionally, cognitively and
physically—require taking their courses all the way
through. The prognostic of recovery for a patient or individual who has
sustained a TBI also varies from person to person, but usually, it takes
between a minimum of 2 years to several years for complete and full recovery.
Officially, only 20% to 40% of individual with acquired brain injuries recover
fully (or somewhat fully). But, in reality the cure never really occurs in full
as damage done to the brain is permanent. Nevertheless, with much optimism and
with lots of arduous work and diligent patience, recovery and many changes may
manifest themselves accordingly.
What not to say to a person with ABI?
Relationships, sexual orientation, speech and
oral conversations, communication and verbally done expressions, written work,
word findings and word searches, physical abilities, way of thinking and
personality, sleep patterns, as well as mood and temperament may all differ
substantially as a result of a serious traumatic episode. TBI impact on relationships
a lot more in the post-trauma recovery periods. At times, relationships turn
into break-ups and separation, and even divorce. Sexual orientation also
changes drastically as a result of a brain injury. Some individuals have the
tendency to have lesser orgasm and others may have an increase in orgasm. The
urge and the need for sexual encounters and sexual intercourses vary from
person to person. Speech and conversations may be very distorted and garbled.
Word usages and word searches are very common difficult areas to those who may
have not been exposed to a particular language at birth. Speech pathology and
speech therapy are the best options to remedy the cases of garbled speeches and
unsteady word finding in certain individuals. Physical abilities are either
reduced or may require a boost in overall exertions. Physiotherapy, massage
therapy and acupuncture, weight-lifting, deep breathing and calming the mind
and racing thoughts all need to find suitable spots in those people who have to
deal with recovery from a severe TBI. Sleep disorder and sleep patterns are
often a very troublesome in the post-traumatic periods. Sleep tests, sleeping
pills and psychiatric interventions may help reduce risks of obtaining seizures
as a result of lack of quality sleep. Mood instability and mood disorders are
common problems and show of high concerns to many families who deal with
post-TBI consequences. Mood swings are often the result of a trauma. This may
be considered as a mental health problem. However, ABI (Acquired Brain Injury)
and TBI (Traumatic Brain Injury) are not considered as being part and parcel of
the mental health faculty as they are based on acquired forms of injuries
sustained to the brain. Therefore, mood disorders, although being treated under
same guidelines and same treating factors of the mental health program, are
consequently only the main focal point of an ABI and a post-traumatic condition.
Irritability, anger and frustration are
also results of post-trauma. The latter is very common and is frequently
addressed as an issue and concern to families that face such testing moments.
With time and through healing processes made evident, irritability and anger
decreases in most cases of post-trauma. Sometimes, anger management is required
to investigate the problem further, but usually, therapists and medical
professionals are the best judges that interfere in the circumstances of deep
provoking anger, agitation and violent reactions. Law enforcement authorities and
the police may need to put a halt and calm such situations in order to prevent obscene
and vulgar language uses, violent reactions and destruction of properties.
Rehabilitation After TBI
Invisible Disability
Counseling and psychotherapy are also in deep
needs after a severe TBI. Social workers, psychotherapists, psychiatrists,
occupational therapists, rehabilitation therapists, and cognitive behaviour
consultants all need to play their shares in the role of a supportive team that
will ascertain the prospective recovery of the individual who has suffered the
terrible blow. In many cases, there is the need for reeducation and
reassessment of knowledge, and based on the criteria and requirements of the
case that is being dealt with, counseling, speech pathology, constant
monitoring of behaviour, constant support, and patient acknowledgement of
certain key factors affecting the person’s daily life and daily living is
further bettered and maintained with stronger adhered conditions. Those who
have accrued cognitive and behavioral deficits will be given occupational
therapists to balance their day to day activities. Assistive devices such as
wheel-chairs and gait aids are provided. Walkers and canes are also introduced
in the lives of such individuals. Environmental manipulations, such as:
installation rifts, ramps and rails, and bathroom alterations facilitate the
basic activities of a person who has a TBI. Family education and family
support, counseling and social assistance are provided to those in need. People
with catastrophic (extremely severe) injuries have the following provided to
their homes: bathrooms modifications, grab rails, non-skid flooring. Constant
monitoring by a healthcare professional will assure and ascertain that
commuting, and social outings are done in a smooth and safe manner.
How the brain works?
Fatigue Management
TBI
is one such medical concern and issue that requires very adaptable support and
adequate facilities, in order for the person in question to be able to restore
his or her lifestyle. Medical professionals, medical requirements and medical
interventions create very effective roles in the ways the person can find his
or her way back on the right track or right pathway. A person with TBI, given the
certainty of a convenient rehabilitation facility, would be able to find better
hopes and more prospect in an eventual future while being optimistic and while
setting positive goals. Survivors of TBI face continuous challenges even many
years after having been treated fully. The impact of injury sustained to the
head and the permanent scars that are the consequent end result of the acquired
brain injury need continuous monitoring, and a sequential pattern of behaviour
and symptoms observed would deduce further setbacks or eventual deteriorations
or ameliorations. Despite all, and however great rehabilitation may be, TBI can
not be healed in its entirety. Ultimately, it is the patient’s motivation and personal
insightful guidance which will ensure that signs for an eventual getting back
to a normal life may be guaranteed.
Statistics of severity of cases of Traumatic Brain Injuries
