Support - and Effort - Is Everything

I work in a rehab/assisted living facility for patients with post-acute traumatic brain injuries.

Our patients are all examples of how the course of one's life can change, dramatically, in a split second.

Many of them do have full, or as close to full as possible, recoveries. But there are also many whose lives will be permanently changed. They will have to learn to adapt to and live with the new limitations that have been imposed on their bodies and minds.

Each brain injury is as unique as each patient.

Some patients work really hard and make great progress. Some start out making progress, but then give up as the therapies get more challenging.

The road to recovery is very difficult and painful.

There are some patients who do seem to make much effort in the first place. There are some where effort does not seem possible, either through physical or mental means.

And we have also had patients who have surprised us - patients that we thought would not get better but who have managed to make great strides.

One of those patients was the Appalachian hillbilly college history professor who was a passenger in a car that was involved in a serious wreck.

She was a level 3 (requiring 24-hour within arm's reach supervision) for the longest time. The hillbilly prof was confused, not lucid a good part of the time, and not aware of her safety.

She also had mental health issues, which were controlled with medication. After her brain injury, however, they percolated to the top, often making her delusional or downright paranoid.

When the hillbilly prof first came in, we could not even allow her to stand up and walk to the bathroom at night because that would involve having to put on her back brace, which she was supposed to have off at night. We had to give her the bed pan instead.

She had at least 16 surgeries within a month of her accident, some of them being skin grafts.

The hillbilly prof now is walking on her own, and has been for quite some time. She occasionally gets confused and disoriented, but she's nowhere near as bad as she used to be.

Being originally from Appalachia and proud of her hillbilly roots, music is a big thing in the hillbilly prof's life. In addition to being a history professor, she is also a musician, as is her husband (who is also a music professor). A major step in her progress involved her love for music, when she went from sustaining a note for 5 seconds to sustaining one for 25 seconds. She and her husband were ecstatic.

The hillbilly prof may be getting discharged soon. She may not be able to return to her job as college professor because her brain is still a bit scrambled from the accident. But who knows? Maybe that miracle will happen further down the road.

Like the cowboy, the Appalachian hillbilly prof has come a long way. And like the cowboy, she has had incredible family support. Her husband has been down to the center nearly every day to visit with her and take her out to dinner or bring her back home so that she could enjoy the company of their one million cats.

(Please do read about the cowboy, especially the beginning of the blog that tells you what his story was. Watching the cowboy's progress on the road to recovery is like watching a miracle unfold! His story has got to be one of the most inspiring stories to cross my work's threshold.)

It seems as though the patients with the biggest family support are the ones who make the biggest progress. And that makes me believe that family involvement is a very important component to a patient's recovery.

We had one patient who had very little family support. Part of it could have been that her family lived far away. But even then, they could have called more often. We did have video phones for patients whose families were more than 100 miles away.

She had not seen her kids in 15 - 18 months. In fact, she could not even talk to them on the phone. For some reason, the rest of her family would not permit this patient contact with her kids, which further increased her sorrow.

The patient was wheelchair bound and needed assistance in dressing, bathing, and going to the bathroom.

One of her goals was to be able to put her arms around her kids and hug them.

For awhile, she was showing improvement - increasing the time she was on the treadmill or increasing the distance she was able to walk down the hall without her wheelchair.

What held her back was her fear. She had fallen a couple of times and was afraid that she was going to fall again. She allowed that fear to control her. So eventually, she stopped making the effort that she was making before. The progress that she made stopped and then took several backwards steps.

The patient was discharged and sent to live in a nursing home that was closer to her family.

One cannot help but wonder how far this patient would have gone if she had more family support - if her family was there, urging her on, and urging her not to give up.