Brain Injury Recovery and Coping: a Long Road - Part 1
By Ashleigh Bryant
A graphical example of brain activity is displayed on a monitor at the VA medical center in Minneapolis.
The road to recovery from traumatic brain injury (TBI) is something of a “watch and wait” process that can sideline patients from their normal, daily functions indefinitely. There is no timetable laid out to mend our most complex vital organ once it’s damaged, which can be one of the more frustrating parts of recovering from this unseen injury.
The Defense and Veteran Brain Injury Center estimates that most cases of mild traumatic brain injury, or concussions, heal within one to three months. But the symptoms accompanying even the most mild head injuries are enough to alter a person’s cognitive function, personality and behavior.
“Just within the last decade, we have seen hundreds of thousands of veterans come home with brain injuries of varying severity,” said Washington Headquarters Executive Director Barry Jesinoski. “It has been difficult for the VA and the civilian medical community to respond to such a high influx of TBI patients in such a short timeframe.”
It has been even more challenging, it seems, to come up with definitive answers for those suffering from these injuries and for those helping them to heal.
For many veterans, the signs of brain injury are easy to miss. There’s just something…a little off. It may be a slight disconnect between the thought process and speech, fuzzy recollection and trouble remembering simple things and, of course, the ensuing frustration with these difficulties.
“Proper screening is absolutely crucial to ensuring an accurate diagnosis,” Jesinoski said. “Another key factor is that veterans must do their part in the recovery process.”
Experts in the field agree that proper diet, rest, and exercise, as well as stress reduction are key to the recovery process. “Number one, I think stress reduction is very important when you’re dealing with a traumatic brain injury and concussions, at least until the patient is asymptomatic.” said Dr. Ricardo Komotar, Assistant Professor of Clinical Neurosurgery at the University of Miami Hospital.
But stress reduction can be a tall order for many TBI patients. Perhaps most frustrating is the lack of a clear therapy or treatment once the injury has been properly diagnosed. Army veteran Jeffrey Hummert was injured in Iraq in 2005, and after two difficult years of fighting to stay in the service, he ultimately received a medical discharge.
His advice for fellow veterans is to stay open-minded and to keep fighting for what is important. “Keep pushing through it and come to the mindset that you’re not going to let it beat you, but you have to come to that decision,” said Hummert. “Your family can’t do it for you. Give yourself a reason, be it your family or something else. You just can’t let it steal your life.”
There are suggested methods for recovering or at least improving cognitive function. Incorporating the five senses (feel, sound, sight, taste and smell) into memory-making and associating, or “hooking” new information to something already known are ways that can help patients who have difficulty with recollection.
Talk therapy is also something that, while not for every patient, can at least offer some level of stress relief. And so-called brain “exercises” that help to sharpen cognitive skills may be useful, though this has yet to be clinically verified. For other memory troubles, written reminders can be extremely useful in prompting recollection.
Today there are a number of smartphone applications that can also help keep track of family calendars, appointments, medication schedules and refill notifications. Veterans suffering from TBI may also be eligible for a personal digital assistant (PDA) from the VA, by making the request through their case manager or primary care physician.
Hummert said veterans should try to involve the whole family in the process rather than going it alone, and he advises caregivers to be understanding through the recovery. “Sometimes we do get a little angry or frustrated with everything, and sometimes it comes out at the wrong times,” he explained. “There may be a time when we are dealing with something else and our priorities may not match up with yours. Know that it’s not about you. Don’t take it personally.”
Any spouse, parent or other person devoted to the care of an injured or ill veteran can tell you the recovery process can be challenging and demanding, albeit a labor of love. For caregivers of veterans with cognitive impairments, the job can be particularly difficult.
Researchers at the Minneapolis VA medical center recently studied how caregivers of veterans with stigmatized conditions like TBI may experience discrimination or stigma-by-association. Veterans’ caregivers were asked about their role in recovery in the months following rehabilitation.
“We found that generally inpatient treatment periods were more stressful for caregivers than at home,” said Dr. Joan Griffin, Assistant Professor at the University of Minnesota Department of Medicine. “Once they return home, the reality of normal life sets in, and things slow down. It helps the family to realize that the patient will never really be the same again.”
This truth can either make or break a family. Heather Hummert began writing about her role as a caregiver after her husband, Jeffrey, was discharged from the Army. She is now the vice president of the non-profit Family of a Vet organization, which provides resources to help veterans and their loved ones “survive and thrive in life after combat.”
“You are in a new world, and it’s never going to be the same. The sooner you realize that, grieve for it and accept it, the sooner you can begin to build a new life that can be beautiful, rewarding and full of possibilities,” said Hummert.
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